Hair Cosmetics for the Hair Loss Patient

Medical professionals that treat patients with alopecia usually lack knowledge about hair cosmetics. Trichologists focus on hair cycling and growth problems and not on the hair shaft integrity. This may lead to abandon of the use of the prescribed treatment, such as topical minoxidil or to inadequate traumatic grooming habits that may jeopardize hair follicle health. Shampoos, hair dyes, and hair-straightening products may alter hair fiber structure, remove lipids, and elude protein. Hair procedures such as hair dying and straightening have side effects and health concerns, especially for pregnant women or sensitive hair and scalp patients. Hair breakage, follicle traction, frizz, contact dermatitis, and mutagenicity are possible side effects of hair cosmetics misuse. The proper use of hair care products may help to increase patients' adherence to alopecia treatments and avoid health problems related to inadequate application of hair cosmetics and procedures.

Expert opinion on current and emerging treatment options in androgenetic alopecia and telogen effluvium: an Indian perspective

<p class="abstract">The diagnosis and management of hair loss needs an organized and systematic approach for recognizing pattern of hair loss and identification of hair loss etiology. Early and specific diagnosis is essential to initiate appropriate treatment in the early phases of hair loss. Topical minoxidil and oral finasteride are the only approved drugs for androgenetic alopecia (AGA). Various other treatment options are widely used but have limited clinical evidence. Similarly, there are no specific treatments recommended for telogen effluvium (TE). However, the treatment may become challenging with increasing availability of new formulations and drugs with no substantial evidence to support them. Multiple focused group discussions were conducted among Indian dermatologists to gain expert opinion on appropriate management of AGA and TE in the current scenario. This article summarizes the consensus clinical viewpoints for topical and oral medications, role of nutritional supplements, and other adjunctive therapies in managing AGA and TE. The panel highlighted that the choice of treatment for AGA and TE depends on the individual hair loss pattern and response to medications. A brief discussion on the use of shampoos and procedures has also been highlighted. </p>

Immunomorphological features of female patient’s skin with androgenetic alopecia in the treatment of platelet-rich plasma in combination with topical minoxidil 2 % lotion

The aim. The research was provided to obtain immunohistochemical changes in scalp biopsies of female patients with androgenetic alopecia (AGA) I-II stages according to the Ludwig scale and to detect possible changes after usage of platelet-rich plasma (PRP) injections in combination with topical minoxidil 2 % lotion. Materials and methods. Skin biopsies of 30 patients with AGA were examined by immunohistochemistry before and after treatment, which lasted for 3 months and included 3 PRP sessions (once per month) and topical application of minoxidil 2 % lotion twice daily. Results. It was found that AGA is accompanied by inflammatory perifollicular infiltration by T-lymphocytes CD3 +, CD4 + and CD8 +, macrophages (CD68 +); imbalance of growth polypeptides VEGF, TGF-β1, EGFR; accumulation of oxidative stress enzymes eNOS and iNOS; accumulation of pathological fraction of Collagen IV. The use of platelet-rich plasma in combination with topical 2 % minoxidil as AGA therapy leads to the normalization of immunohistochemical parameters of the skin, which indicates the possibility of its use for long-term therapeutic effect. Conclusions. This study supplemented the understanding of the pathogenesis of AGA and serves as the basis for improving treatment regimens for this pathology. But more research is required to further study the pathomorphology of androgenetic alopecia and to standardize the technique of using platelet-rich plasma in patients with this disease.

Managing patterned hair loss – a hair raising task!

Diffuse alopecia wields a significant psychosocial burden by virtue of its clinical presentation and visibility. Patterned alopecia is an umbrella term with the focus point being androgen-mediated alopecias - androgenetic alopecia/male pattern baldness/male androgenetic alopecia and female pattern hair loss/female androgenetic alopecia, both of which have a genetic susceptibility that alters the follicular sensitivity to circulating androgens. Diffuse alopecia affects nearly half the population based on weighted averages. It may present with hair shedding and hair thinning (miniaturization) or a combination. With the female variant, the role of androgens is not fully delineated; hence, the term female pattern hair loss which has replaced prior nomenclature. Managing patterned hair loss has seen a sea change in the last decade, moving well beyond the FDA-approved modalities - topical minoxidil and oral finasteride. Through this short review, the authors have attempted to condense existing information into a ready reference.

Retinal artery occlusion as a probable idiosyncratic reaction to topical minoxidil: a case report

Background Minoxidil hair formulation is commonly used for the treatment of male or female androgenic alopecia. This over-the-counter product is considered safe, but should be used with caution. Ocular side effects following topical minoxidil use are rarely reported. In this paper, we report a rare case of inferior hemiretinal artery occlusion possibly caused by topical 5% minoxidil treatment. Case description A 21-year-old Asian Indian male presented to the retina clinic with sudden onset blurring of vision and superior visual field loss in the right eye since morning. He was diagnosed with androgenic alopecia and was on treatment with topical 5% minoxidil spray twice a day for the last 3 years. On examination, his corrected distance visual acuity was 6/6, N6 in both eyes. Anterior segment examination and intraocular pressure in both eyes and left eye fundus were within normal limits. Right eye fundus examination showed features suggestive of inferior hemiretinal artery occlusion, which were confirmed on fluorescein angiography and optical coherence tomography. A detailed systemic evaluation and investigations (blood pressure, random blood sugar, hematological and coagulation profile, serum homocysteine level, Mantoux test, chest x-ray, cardiac two-dimensional echography, thyroid function test, and immunological profile) did not detect any abnormalities. The ocular condition and its visual prognosis were explained to the patient, and he was asked to review after 4 weeks. Conclusion Though there is no definite cause–outcome relationship between topical minoxidil use and retinal artery occlusion development, this possibility should be kept in mind when observing retinal vascular occlusion cases with concurrent use of topical minoxidil.

Comparative study between the efficacy of topical sildenafil and topical minoxidil in the treatment of male androgenic alopecia

Background Androgenic alopecia is the most common form of alopecia in men and women. Its incidence increase with age, many treatment modalities are available but results are variable. Androgenetic alopecia is a hereditary thinning of the hair induced by androgens in genetically susceptible men and women. Also known as male-pattern hair loss or common baldness in men and female-pattern hair loss in women. Thinning of hair usually begins between 12 and 40 years old in males and females. Inheritance is polygenic. Aim of the study To evaluate and compare the efficacy, safety and side effects of topical sildenafil and topical minoxidil in the treatment of androgenic alopecia Patients and methods This exploratory pilot study included 30 male patients suffering from androgenic alopecia. Included patients were divided into 2 equal groups based on treatment received; one group received 1% topical sildenafil and the other group received 55 topical minoxidil. Assessment of treatment response was done using trichoscopy. Results Sildenafil treated group showed statistically significant increase in VH and TH count at 18 cm point, 24 cm point after treatment compared to before treatment. While, temporal side showed statistically significant increase in VH only. minoxidil treated group showed statistically significant increase in TH count, T/V hair ratio and hair thickness at 18 cm point and temporal side after treatment compared to before treatment. VH count was significantly decreased after treatment compared to before treatment at 18 cm point. At 24 cm point, only TH was significantly increased after treatment compared to before treatment.

Case Report: Successful Use of Minoxidil to Promote Facial Hair Growth in an Adolescent Transgender Male

Increasing numbers of trans and gender diverse young people are presenting to health services seeking gender-affirming medical care. While testosterone therapy in transgender males is generally effective in inducing masculinization, some adolescents encounter barriers to accessing such treatment or may not wish to experience all the changes that usually accompany testosterone. Here, we describe the case of a 17 year old trans male who presented with gender dysphoria but was initially unable to start testosterone therapy. Due to a desire for facial hair, he was therefore treated with topical minoxidil, an easily accessible, over-the-counter medication that has been used to treat androgenic alopecia for several decades. In this case, minoxidil was applied regularly to the lower face and, after three months of treatment, he developed obvious pigmented facial hair that was sufficient to help him avoid being misgendered. The only reported side effect was excessive skin dryness. Unexpectedly, despite no direct application to other areas, there was also an increase in pigmented body hair, suggestive of systemic absorption and effect. Given its long-standing use and safety record in the management of alopecia, minoxidil might thus represent a useful treatment option for trans males who desire an increase in facial hair.

Topical Minoxidil Exposures and Toxicoses in Dogs and Cats: 211 Cases (2001–2019)

ABSTRACT Topical minoxidil is a medication for hair loss, initially available in the United States by prescription only and available since 1996 as an over-the-counter product. To determine the epidemiology of minoxidil exposures and toxicoses in dogs and cats, 211 dog and cat cases with topical minoxidil exposure were identified from the American Society for the Prevention of Cruelty to Animals Animal Poison Control Center database. In 87 cases with clinical signs of toxicosis (62 cats, 25 dogs), case narratives were reviewed and coded for exposure-related circumstances. Unintentional delivery, especially while pet owners applied minoxidil for his/her own hair loss (e.g., pet licked owner’s skin or pillowcase, pet was splashed during a medication spill), was the most common cat exposure circumstance. Exploratory behavior (e.g., searching through trash) was the most common dog exposure circumstance. Clinical signs occurred in dogs and cats even with low exposure amounts, such as drops or licks. In patients that developed clinical signs, most developed moderate or major illness (56.0% dogs, 59.7% cats). Death occurred in 8/62 (12.9%) cats that developed clinical signs after the pet owner’s minoxidil use. Pet owners should be educated on the risk of dog and cat toxicosis from accidental minoxidil exposure.