Beware of the Impostors—Scalp Pathology Primer for the Hair Transplant Surgeon

Histopathological features are important for the practicing hair transplant surgeon to ensure proper case selection, diagnosis, choice of proper treatment, and successful outcome. While the primary focus of the hair transplant surgeon is androgenetic alopecia (AGA), it is important to be aware of other conditions that can mimic AGA, whose treatment may be different. This article outlines some of these conditions such as scarring alopecias, alopecia areata, etc., and how to distinguish them. Proper identification will ensure proper treatment and avoid potential missteps in management.     

Understanding Pattern Hair Loss—Hair Biology Impacted by Genes,Androgens, Prostaglandins and Epigenetic Factors

Pattern hair loss (PHL) is the most frequent cause of hair loss in men and women, accounting for 65% of consultations in a hair referral center. PHL is understood to represent a hereditary, age-dependent progressive thinning of the scalp hair, which follows distinct clinical patterns with notable differences depending on sex and age of onset. Clinical and investigative advances have helped us to understand some of the pathogenic steps, leading to PHL. Besides genetic factors and peculiarities of androgen metabolism, additional pathogenic factors that are suspected include microbiomata, oxidative stress, and microinflammation. While further suspects are likely to be exposed, individual diversity of causal agents, as well as of the sequence of events, or combined factors, must be kept in mind. A large number of therapeutic molecules claimed to be active and patented in this field, and their limited efficacy in offering a definitive cure of PHL confirm the complexity of PHL. The aim of therapy is to retard progression of hair thinning and increase hair coverage of the scalp. As yet, two FDA-approved drugs are available for this purpose, oral finasteride, and topical solution of minoxidil. Variations in posology and formulation allow for an enhancement of patient comfort and treatment efficacy. Antiandrogen treatments in women with normal androgen levels have questionable efficacy while having health risks.     

毛囊干细胞结合电纺纳米丝素纤维构建组织工程尿道膜片的体外研究

目的：探索毛囊干细胞结合电纺纳米丝素纤维,构建组织工程尿道膜片的可行性。方法使用酶消化法分离兔毛囊细胞,利用流式细胞仪分选毛囊干细胞,体外原代培养扩增,计算细胞的最大扩增倍数及克隆形成率;使用流式细胞仪检测细胞K19、p63、CD29的阳性表达率。将毛囊干细胞接种在电纺纳米丝素纤维支架上,构建组织工程尿道。应用组织学、荧光染色法观察组织工程尿道的体外构建情况。结果兔毛囊干细胞与兔毛囊细胞的最大扩增倍数分别为（5.92±0.77）×10^4倍和（6.61±3.62）×10^3倍;兔毛囊干细胞与兔毛囊细胞的克隆形成率分别为（9.07±1.18）%和（3.95±1.01）%。K19、p63、CD29在毛囊干细胞中表达率分别为（89.36±6.69）%、（92.10±5.49）%和（89.98±6.89）%;在兔毛囊细胞中分别为（39.38±2.20）%、（40.78±2.61）%和（40.57±2.79）%;毛囊干细胞在支架上能形成复层上皮样结构,AE1/AE3染色阳性。结论兔毛囊干细胞结合电纺纳米丝素纤维,能成功构建组织工程尿道,可用于体内修复的进一步研究。     

A Prospective Six-month Single-blind Study Evaluating Changes in Hair Growth and Quality Using a Nutraceutical Supplement in Men and Women of Diverse Ethnicities

Objective The goal of this study was to assess the perceived efficacy of a standardized nutraceutical to improve hair growth and quality in men and women of various ethnicities with self-perceived hair thinning.MethodsThis prospective, single-blind study enrolled healthy men aged 20 to 55 years (n=47) and premenopausal women aged 20 to 45 years (n=51) with self-perceived, mild-to-moderate hair thinning and included African American, Asian, Hispanic Caucasian and Non-Hispanic Caucasian participants. The nutraceutical supplement (Nutrafol® Men or Women Capsules, Nutraceutical Wellness Inc., New York, New York) was taken daily for six months. Subjects were evaluated in the clinic at baseline and Weeks 12 and 24 with two self-assessments at Weeks 4 and 8. Study endpoints were standardized digital imaging and investigator rated assessments. Self-assessment questionnaires rated hair growth, hair satisfaction, and lifestyle factors.ResultsInvestigator ratings for baseline hair growth, coverage, density, and volume were significant at Weeks 12 and 24 for all subjects (for each, p<0.001). These significant improvements were seen in 83.7 percent of men and 79.5 percent of women at Week 24. Results were similar across ethnic subgroups with significant benefit at Weeks 12 and 24 (for each, p<0.05). All subjects reported significant improvements in baseline hair appearance/quality, volume/fullness, scalp coverage, thickness, and shedding at Weeks 4, 8, 12 and 24 (for each, p<0.01).ConclusionA standardized nutraceutical supplement improved visible hair growth with less notable shedding based on subjects’ and investigators'' overall perception of treatment benefit for men and women of various ethnic backgrounds.