自体显微毛发移植治疗不同类型瘢痕性秃发的结果分析

近年显微毛发移植技术不断提高,移植后毛发生长更加接近于自然分布状态,成活率明显提高,而自体显微毛发单位移植技术治疗瘢痕性秃发仍存在疗效差异,不同类型的瘢痕疗效差异较大.     

毛发移植术治疗秃发疗效分析

目的应用自体毛发移植术对秃发进行治疗并观察中、远期疗效。方法选择本院2000年2月~2005年7月的638例患者,其中雄激素源性秃发522例,瘢痕性秃发116例,均采用自体毛发移植术治疗,并定期随访。结果移植毛囊成活率分别为96.83%(男性雄激素源型秃发),95.73%(女性雄激素源型秃发),90.52%(瘢痕性秃发)。随访6~68个月未见移植毛发再次脱落。医生满意度为95.14%(607/638),患者满意度为97.49%(622/638)。结论毛发移植技术是一项安全、可靠、有效的治疗方法。可用于雄激素源性秃发和瘢痕性秃发的治疗,远期疗效较好。     

毛发移植

1毛发移植的历史 1800年Baronio成功地在动物身上进行了自体毛发移植：但Dom Ungel(1882年)第一个在临床上用自体毛发移植治疗秃发获得成功：1939年，日本皮肤科医生0kuda应用打孔白体毛发移植法对200例患者进行了治疗，适应证主要是瘢痕性秃发(包括头部、眉毛及胡须等)。这个方法与后来0rentreich的治疗方法几乎相同，随后，Tamura(1943年)和Fujita(1953年)相继     

自体毛发移植术治疗永久性秃发146例疗效观察

应用毛发移植术对146例永久性秃发患者进行治疗。结果：结果术后平均3个月生长出新发，移植毛发成活率大于90％，原秃发区头发密度得到较大改观，患者较为满意，未见严重并发症。     

《中国雄激素性秃发诊疗指南》解读

雄激素性秃发是最常见的秃发性疾病,对患者心理健康有重要影响。雄激素性秃发的病理生理主要是在二氢睾酮的作用下毛囊逐渐微小化,最后导致毛发由终毛转变为毳毛。中华医学会皮肤性病学分会毛发学组于2014年制定了《中国雄激素性秃发诊疗指南》。该指南推荐BASP分级,男性治疗推荐口服非那雄胺和外用米诺地尔,具有良好疗效和安全性。女性推荐口服螺内酯和环丙孕酮与外用米诺地尔,疗效较男性略差。无论男女,药物治疗推荐早治疗和足够疗程。对于药物治疗疗效差,且有足够供发区的患者可进行自体毛发移植,对于药物疗效差,且不宜进行毛发移植者可选择发片或假发等补救措施。     

雄激素性秃发治疗进展与现代毛发移植技术进修班通知

正由江苏省人民医院(南京医科大学第一附属医院)主办的国家级继续医学教育Ⅰ类学分10分项目"雄激素性秃发治疗进展与现代毛发移植技术培训班"为全年开放性学习班,学员报名满5名即可开班教学。学习班由全国皮肤学界的知名专家授课,主要讲授内容有:毛发的结构特点及毛囊生理,常见毛发疾病诊治及进展,现代微创毛发移植技术(包括FUT+FUE)和人工毛发移植技术,并通过学员的亲身实践操作(毛囊分离、毛囊提取、毛发植入及毛发移植手术),掌握自体毛发移植和人工毛发移植技术的全过程。本课程最     

雄激素性秃发治疗进展与现代毛发移植技术进修班通知

正由江苏省人民医院(南京医科大学第一附属医院)主办的国家级继续医学教育Ⅰ类学分10分项目"雄激素性秃发治疗进展与现代毛发移植技术培训班"为全年开放性学习班,学员报名满5名即可开班教学。学习班由全国皮肤学界的知名专家授课,主要讲授内容有:毛发的结构特点及毛囊生理,常见毛发疾病诊治及进展,现代微创毛发移植技术(包括FUT+FUE)和人工毛发移植技术,并通过学员的亲身实践操作(毛囊分离、毛囊提取、毛发植入及毛发移植手术),掌握自体毛发移植和人工毛发移植技术的全过程。本课程最     

现代毛发修复外科

外科毛发修复技术经历了头皮缩减术、皮瓣修复术、游离毛发移植术 3个阶段。目前 ,小型移植、微型移植、毛囊移植在临床普遍使用 ,和药物治疗相比 ,是治疗男性型秃发可靠、显效的方法。介绍了毛发修复外科的历史、主要研究内容、最新研究进展及前景 ,详细讨论了毛发毛囊移植过程的技术要领 ,分析了手术并发症及患者不满意的原因并提出对策。     

浙江省毛发移植与头面部微创美容新进展学习班暨第三届杭州市整形与显微外科疑难病例讨论会通知北大核心CSCD

为了促进对国内外最新毛发移植与头面部微创外科技术水平的了解,推动毛发移植技术的普及和拓展,并展示最新微创注射技术以及在治疗头面部血管瘤和血管畸形中的应用,杭州市第一人民医院定于2013年5月16—18日在杭州梅地亚宾馆举办浙江省继续医学教育项目“毛发移植与头面部微创美容新进展学习班”。邀请到亚洲毛发移植协会主席TommyHwang教授,韩国毛发移植医师Dae—young教授,上海华山医院毛发移植中心吴文育教授及血管瘤、血管畸形治疗专家山东省立医院霍然教授、武汉儿童医院秦增辉教授现场授课。授课主要内容：毛发移植术前发际线设计要点,毛发移植术中麻醉方法及技巧,毛发移植术后的护理及并发症处理,超精密毛发移植在男性雄激素性秃发、睫毛、眉毛、阴毛、胡须中的应用,毛发移植在瘢痕性秃发中的应用,FUE技术应用及要点,女性额头过高发际线美人尖重建,皮肤填充剂的应用,聚桂醇在血管畸形治疗中的应用,同时邀请具有丰富临床经验的整形外科专家讲解有关注射美容的最新进展。参加本次学习班者都将获赠《毛发整形美容学》教材一本,     

毛发移植

毛发移植用于治疗多种原因引起的脱发已经取得很大进展,其方法从最初的大型毛胚移植发展到现在的微小毛胚移植,技术日渐成熟,手术效果得到明显改善,患者满意度也大大提高。与药物治疗相比,毛发移植能在相对较短的时间内改善外观,而且这种改善是永久性的。     

Severe alopecia areata treated with systemic corticosteroids

Background Treatment of severe alopecia areata is difficult, and most efforts to successfully treat this condition have been disappointing. Systemic corticosteroids have been demonstrated as an effective treatment of severe alopecia areata. Methods Eighteen patients with alopecia areata (extensive patchy and totalis universalis types) were treated with systemic corticosteroids. Results Satisfactory hair regrowth was achieved in seven patients (38.9%). Hair fall subsequently occurred in all of these patients on discontinuation or tapering of corticosteroid therapy. Conclusions Systemic corticosteroid therapy does not prevent the spread or relapse of severe alopecia areata and, when complete regrowth is obtained, it is rarely maintained off therapy.     

Melatonin increases anagen hair rate in women with androgenetic alopecia or diffuse alopecia: results of a pilot randomized controlled trial

BACKGROUND: In addition to the well-known hormonal influences of testosterone and dihydrotestosterone on the hair cycle, melatonin has been reported to have a beneficial effect on hair growth in animals. The effect of melatonin on hair growth in humans has not been investigated so far. OBJECTIVES: To examine whether topically applied melatonin influences anagen and telogen hair rate in women with androgenetic or diffuse hair loss. METHODS: A double-blind, randomized, placebo-controlled study was conducted in 40 women suffering from diffuse alopecia or androgenetic alopecia. A 0.1% melatonin or a placebo solution was applied on the scalp once daily for 6 months and trichograms were performed to assess anagen and telogen hair rate. To monitor effects of treatment on physiological melatonin levels, blood samples were taken over the whole study period. RESULTS: Melatonin led to a significantly increased anagen hair rate in occipital hair in women with androgenetic hair loss compared with placebo (n=12; P=0.012). For frontal hair, melatonin gave a significant increase in the group with diffuse alopecia (n=28; P=0.046). The occipital hair samples of patients with diffuse alopecia and the frontal hair counts of those with androgenetic alopecia also showed an increase of anagen hair, but differences were not significant. Plasma melatonin levels increased under treatment with melatonin, but did not exceed the physiological night peak. CONCLUSIONS: To the authors' knowledge, this pilot study is the first to show that topically applied melatonin might influence hair growth in humans in vivo. The mode of action is not known, but the effect might result from an induction of anagen phase.     

Diagnosis and management of the hair loss patient

Telogen effluvium, alopecia areata, traction/chemical alopecia, and androgenetic alopecia account for more than 90 percent of all causes of hair loss in patients presenting to the dermatologist's office. A thorough understanding of these hair diseases will enable the practicing dermatologist to effectively manage the vast majority of patients who present with scalp hair loss.     

甲氨蝶呤是否能有效安全地维持全秃患者的头发再生? 一个经过严格评价议题

Alopecia areata (AA) is a common disorder causing hair loss, which can range from patches, to complete hair loss on the scalp (alopecia totalis), or involving all hair‐bearing sites (alopecia universalis). It can cause anxiety, depression and low self‐esteem. Treatment can be difficult – there are several options but they don't always work and can have unwanted side effects. Hair can in fact regrow without any treatment. The aim of this study was to assess the current evidence regarding use of a drug called methotrexate for getting hair to regrow, and then remain, in people with alopecia. The authors looked at 13 studies comprising 226 patients with alopecia varying from 30% hair loss to alopecia universalis at the start. Methotrexate was usually given with drugs called systemic corticosteroids to start hair regrowth rather than regrowth maintenance. Regrowth, defined as anything from 50% to complete regrowth, was reported in 20‐90% of patients. Relapse (meaning hair re‐grew but then fell out again) occurred in 20‐80%, with variable regrowth on retreatment. Unwanted side effects ranged from 7‐60%. The authors found insufficient evidence to conclude whether methotrexate is useful for maintaining regrowth in extensive alopecia areata. They found some evidence to suggest that hair regrowth may be started by methotrexate when used in combination with systemic corticosteroids, but it was difficult to say which of the treatments this was due to, or if the hair was going to regrow anyway. Further trials are needed.     

Advances in the treatment of male androgenetic alopecia: a brief review of finasteride studies

Finasteride is a type 2 5a-reductase inhibitor and therefore mimics the biochemical profile of inherited type 2 5a-reductase deficiency in men. It was developed to grow hair in androgenetic alopecia and shrink benign prostatic hyperplasia. Various clinical trials of finasteride have confirmed its beneficial effects in androgenetic alopecia in males, but not in females. It can produce visible hair growth in up to 66% of men with mild to moderate alopecia, but importantly can stop hair loss in 91% of patients. In long-term finasteride studies, placebo patients were characterized by significant and progressive hair loss. It can be concluded that finasteride prevents further hair loss by actually continuing to grow enough hair to preserve scalp coverage. This is confirmed by the loss of hair following withdrawal of finasteride in such cases. The proven preservative effect of finasteride, in addition to its restorative effect, is a strong indication for prescribing it in early cases of androgenetic alopecia before much hair has been lost.     

单株和多株混合自体头发移植术在男型秃发的应用

目的：探讨单多株自体头发移植术治疗男型秃发的效果。方法：采用单、多株混合自体头发移植术式治疗男型秃发12例（A组）与采用多株自体准确性移植术治疗31例（B组）对照。结果：①A组或B组其头发的手术成功率均为100％,术后无任何不良反应;②采用单、多株自体头发移植术治疗的美容效果及自然度比多株自体头发移植术为好,病人自评很满意为75％,满意率为100％,而采用多株自体头发移植术的分别为16％和77．4％,差异有显著性（P＜0．005）。结论：单、多株自体头发移植术治疗男型秃发的美容效果优于多株自体头发移植术。     

Topical minoxidil for hair regrowth

Minoxidil, a potent peripheral vasodilator used orally for refractory hypertension, has produced hypertrichosis. To determine the efficacy and safety of 1% or 5% topical minoxidil for the stimulation of scalp hair regrowth, we studied fifteen normotensive patients, five with androgenic alopecia and ten with alopecia areata diagnosed clinically and by biopsy, for 12 months. Three of five patients with androgenic alopecia using 5% minoxidil for 12 months noted hair regrowth, ranging from minimally observable hair to an appreciable restoration of larger, pigmented, terminal hair in one patient. Among the patients with androgenic alopecia, regrowth response corresponded to the serum minoxidil blood levels. None of the patients with alopecia areata receiving either 1% or 5% minoxidil noted hair regrowth despite comparable minoxidil blood levels. Improved local absorption of topical minoxidil solution may promote hair regrowth in androgenic alopecia.     

Female androgenetic alopecia: An update

Androgenetic alopecia is an androgen dependent disorder occurring in genetically susceptible individuals. The pattern of hair loss in women differs from that of classical male pattern alopecia, being more diffuse and with retention of the frontal hair line in most cases. Characteristic histopathological changes occur but biopsy is rarely helpful in diagnosis. Although research has shown subtle alterations in the androgen status of women with androgenetic alopecia, most patients presenting with this disorder are normal endocrinologically. Anti-androgen therapy will result in some improvement in up to 50% of patients after 6 to 12 months of therapy, but in practice will usually only decrease the rate of hair loss and not result in new hair growth.