Important Note: The following information is provided for your education. It should not be relied upon for personal diagnosis or treatment. If you believe that a particular therapy applies to you or someone you care about, be sure to consult a doctor before trying it.
   

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Previous Hair Loss Research: 2002-2006   
The Hair Loss File also contains summaries of past research that has shown promise and may still be standard practice among many physicians. To download earlier research findings on Hair Loss, click HERE.
 

Latest Research on Hair Loss
     
Arch Dermatol. 2008 Jun;144(6):759-62.
Standardizing the 60-second hair count.
Wasko CA, Mackley CL, Sperling LC, Mauger D, Miller JJ.
Department of Dermatology, Baylor College of Medicine, Houston, Texas, USA.

OBJECTIVE: To define the range of normal for a standardized 60-second hair count in men without alopecia. DESIGN: Convenience sample. SETTING: Hospital-based practice. PARTICIPANTS: The study included 60 healthy men (age range, 20-60 years) without evidence of alopecia. MAIN OUTCOME MEASURE: Range of normal for a standardized 60-second hair count. RESULTS: Among the 20- through 40-year-old men, the shedding range was 0 to 78 hairs, with a mean of 10.2 hairs. Among the 41- through 60-year-old men, the range was 0-43 hairs, with a mean of 10.3 hairs. Low intrapatient variability for hair counts was found in both age groups, indicating consistent results on consecutive days for all participants. When repeated 6 months later in both age groups, the hair counts did not change much. The hair counts were repeated and verified by a trained investigator, with results similar to those of subject hair counts. CONCLUSION: A properly performed 60-second hair count is a simple, practical, and reliable tool for the assessment of hair shedding.

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Curr Drug Saf. 2006 Aug;1(3):301-5.
Drug-induced hair disorders.
Piraccini BM, Iorizzo M, Rech G, Tosti A.
Department of Dermatology, University of Bologna, Via Massarenti 1, Bologna, Italy. bmpiracc@med.unibo.it

Drugs may induce hair loss, stimulate hair growth or, more rarely, induce changes in the hair shape and colour. Drug-induced hair loss is usually completely reversible and is, in most cases, a consequence of a toxic effect of the drug on the hair follicle matrix. In rare cases alopecia may be permanent. Depending on type of drug, dosage and patient susceptibility, hair loss presents as telogen effluvium, anagen effluvium or both. Telogen effluvium is also commonly observed after discontinuation of drugs that prolong anagen, such as topical minoxidil and oral contraceptives. Although a large number of drugs have been occasionally reported to produce hair loss, only for a few drugs the relation between drug intake and hair loss has been proven. for the assessment of hair shedding.

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Br J Dermatol. 2008 May;158(5):1121-4. Epub 2008 Mar 20.
Value of hormonal levels in patients with male androgenetic alopecia treated with finasteride: better response in patients under 26 years old.
Camacho FM, García-Hernández MJ, Fernández-Crehuet JL.
Department of Dermatology, Hospital Universitario Virgen Macarena, Avda. Dr Fedriani s/n. 41071 Sevilla, Spain.

Background Finasteride is a 5alpha-reductase inhibitor that has proved to be an effective treatment for men with androgenetic alopecia. Objectives To investigate the hormonal influence of finasteride 1 mg daily on hormonal levels and hair growth in men of different ages and with different degrees of alopecia according to the Hamilton-Norwood scale. Methods Two hundred and seventy men aged 14-58 years with male androgenetic alopecia III-VI Hamilton-Norwood score (II-III Ebling score) were treated with finasteride 1 mg daily. Steroid hormone (free testosterone, 5alpha-dihydrotestosterone, dehydroepiandrosterone-sulphate, delta4-androstenedione, 17-hydroxyprogesterone), prostate-specific antigen (PSA) and sebum levels, and trichogram changes were determined at baseline, and at 6 and 12 months of treatment. Results According to significant hormonal statistical analysis, the patients were divided by age (up to or over 26 years). In the group of patients </= 26 years, higher levels of 5alpha-dihydrotestosterone were found at the beginning of the treatment, but there was a 50% decrease between the onset of treatment and month 12, particularly noticeable at 6 months (P < 0.05) of treatment, running parallel to an improvement of the alopecia and an increase of anagen hairs in the trichogram. At 1 year, PSA levels decreased 20%, particularly in patients > 26 years. No variations in sebum levels were observed. Conclusions High levels of 5alpha-dihydrotestosterone in patients </= 26 years at the beginning of treatment are a predictive factor of good response to treatment with finasteride 1 mg daily.

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J Am Acad Dermatol. 2008 Mar;58(3):395-402.
Subcutaneous efalizumab is not effective in the treatment of alopecia areata.
Price VH, Hordinsky MK, Olsen EA, Roberts JL, Siegfried EC, Rafal ES, Korman NJ, Altrabulsi B, Leung HM, Garovoy MR, Caro I, Whiting DA.
Department of Dermatology, University of California, San Francisco, California, USA. pricev@derm.ucsf.edu

BACKGROUND: Alopecia areata (AA) is a T-cell-mediated autoimmune disease. Efalizumab is a T-cell-targeted therapy approved for the treatment of psoriasis. OBJECTIVE: To assess the efficacy and safety of efalizumab in the treatment of moderate-to-severe AA. METHODS: Sixty-two patients were enrolled into this phase II, placebo-controlled trial. The trial consisted of three 12-week periods-a double-blind treatment period, an open-label efalizumab treatment period, and a safety follow-up. RESULTS: There were no statistical differences between treatment groups in percent hair regrowth, quality-of-life measures, or changes in biologic markers of disease severity after 12 or 24 weeks. In both groups, there was an approximately 8% response rate for hair regrowth (at 12 weeks). Efalizumab was well tolerated. LIMITATIONS: Numbers were too small for certain analyses. CONCLUSION: A 3- to 6-month trial of efalizumab was not effective in promoting hair regrowth in this small cohort of patients with moderate-to-severe AA.

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Ann Dermatol Venereol. 2008 Jan;Spec No 1:25-8.
[Medical corrective make-up in post-chemotherapy]
[Article in French]
Merial-Kieny C, Nocera T, Mery S.
Laboratoires Dermatologiques Avène Les Cauquillous, 81506 Lavaur cedex, France. merial.kieny@pierre-fabre.com

INTRODUCTION: Medical corrective make up can be applied to hide the adverse effects of cancer treatments. The aim of this study was to evaluate the tolerance and the satisfaction of patients needing medical make up to hide the cutaneous side effects induced by chimiotherapy and to improve self-esteem. METHODS: 90 cancer patients were included in this multicentric study. They were being treated by chimiotherapy and had eyebrow alopecia, complexion changes, irregular lip contour or lip dryness. They were made up by socio-esthecians. Photos were taken before and after applications of make up. The patients had to fill in a self-questionnaire at home. The duration of the study varied from 1 to 4 weeks. RESULTS: Included patients were 52 years old. Tolerance was considered to be satisfactory or very satisfactory by 95,4% and 98,9% of the patients for eyebrow pencil corrector and the dual lip and contour corrector, respectively. Questions on quality of live and self-esteem revealed that the medical corrective make up improved the quality of life in general for 81,2% of the patients. This product range enhanced the self-esteem of 76,8% of the patients. Cosmetic agreement was highly satisfactory. CONCLUSION: In this study in which patients were suffering from cancer and treated by chimiotherapy, we showed that medical corrective make up can improve the quality of life with a very good tolerance.

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J Dtsch Dermatol Ges. 2008 Jan 17 [Epub ahead of print]
High-dose intravenous corticosteroid pulse therapy in alopecia areata: Own experience compared with the literature.
Luggen P, Hunziker T.
Department of Dermatology, University of Bern, Switzerland.

Background: Seven prospective studies including 193 patients have been published on high-dose intravenous corticosteroid pulse therapy in alopecia areata (AA).We compare these data with a retrospective analysis of our own consecutive patients. Patients and Methods: Between 1998 and 2002,25 patients with severe AA were treated at the Department of Dermatology, University of Bern, with infusions of 500 mg methylprednisolone on 3 consecutive days. In addition to the inpatient records, in 2004 all patients were followed up by a questionnaire. Results: Four of 10 patients with multifocal AA and 3 of 9 patients with ophiasis-type AA had full re-growth of hair, whereas all 6 patients with AA totalis/universalis failed to respond. Conclusion: Intravenous corticosteroid pulse therapy may be helpful in the treatment of multifocal and ophiasis-type AA.Patients with an initial episode of short duration have better chances for success.

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Br J Dermatol. 2008 Jan;158(1):109-15. Epub 2007 Nov 6.
Topical fulvestrant solution has no effect on male and postmenopausal female androgenetic alopecia: results from two randomized, proof-of-concept studies.
Gassmueller J, Hoffmann R, Webster A.
Bioskin Institute for Dermatological Research and Development GmbH, Poppenbuetteler Bogen 25, 22399 Hamburg, Germany.

Background Androgenetic alopecia (pattern baldness) affects approximately half of all white-skinned men and women over the age of 40 years. Based on preclinical studies in mice in which topical fulvestrant (ICI182,780, an anti-oestrogen) caused telogen hair follicles to enter anagen, thereby causing hair growth, a topical formulation of fulvestrant was developed for the potential treatment of androgenetic alopecia. Objectives To evaluate the efficacy of fulvestrant solution in stimulating hair growth in men and postmenopausal women with androgenetic alopecia in two randomized, phase II, minoxidil- and/or vehicle-controlled studies. Methods One hundred and two white-skinned men aged 18-50 years with Norwood/Hamilton grades III, IIIv, IV, V or Va androgenetic alopecia received topical fulvestrant 70 mg mL(-1) solution, vehicle or minoxidil 2% solution twice daily for 16 weeks. Seventy postmenopausal women with Ludwig grade 1 or 2 androgenetic alopecia received topical fulvestrant 70 mg mL(-1) solution or vehicle twice daily for 16 weeks. The endpoints in both studies were hair density, cumulative hair thickness and hair growth rate, measured by TrichoScan analysis of digital images. Results There were no statistically significant differences favouring fulvestrant over vehicle at study end (day 113) for any of the efficacy parameters in men or women. Statistically significant differences in favour of minoxidil over fulvestrant were seen from day 57 onwards for hair density, cumulative hair thickness and hair growth rate in men. Conclusions These results indicate a lack of effect of topical fulvestrant in the treatment of subjects with androgenetic alopecia. The reasons for this lack of effect remain unclear.

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Dermatol Ther. 2007 Nov-Dec;20(6):436-47.
Basic hair transplantation: 2007.
Sadick NS, White MP.
Weill Medical College of Cornell University, New York, New York, USA.

The most common form of hair loss is androgenic alopecia that affects at least half of the male population by age 50 is speculated to be caused by a change in the balance of androgen hormones. Male hair loss occurs in a characteristic pattern of decreased hair growth where hair becomes progressively finer, less pigmented, ceasing growth completely, and then becoming dislodged from the scalp. Hair loss to some patients is a serious issue that can impart a social and psychologic impact on their life. Hair restoration and transplantation have the potential to provide a solution for this problem; however, it is not effective for every patient. This review article looks at past hair transplantation techniques and studies that have provided the basis for current procedures and new research at how to target successful results.

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Clin Interv Aging. 2007;2(2):189-99.
Female pattern hair loss: current treatment concepts.
Dinh QQ, Sinclair R.
Department of Dermatology, St Vincent's Hospital, Fitzroy, Victoria, Australia.

Fewer than 45% of women go through life with a full head of hair. Female pattern hair loss is the commonest cause of hair loss in women and prevalence increases with advancing age. Affected women may experience psychological distress and impaired social functioning. In most cases the diagnosis can be made clinically and the condition treated medically. While many women using oral antiandrogens and topical minoxidil will regrow some hair, early diagnosis and initiation of treatment is desirable as these treatments are more effective at arresting progression of hair loss than stimulating regrowth. Adjunctive nonpharmacological treatment modalities such as counseling, cosmetic camouflage and hair transplantation are important measures for some patients. The histology of female pattern hair loss is identical to that of male androgenetic alopecia. While the clinical pattern of the hair loss differs between men, the response to oral antiandrogens suggests that female pattern hair loss is an androgen dependant condition, at least in the majority of cases. Female pattern hair loss is a chronic progressive condition. All treatments need to be continued to maintain the effect. An initial therapeutic response often takes 12 or even 24 months. Given this delay, monitoring for treatment effect through clinical photography or standardized clinical severity scales is helpful.

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J Eur Acad Dermatol Venereol. 2007 Nov 12 [Epub ahead of print]
Alopecia areata: topical immunotherapy treatment with diphencyprone.
Avgerinou G, Gregoriou S, Rigopoulos D, Stratigos A, Kalogeromitros D, Katsambas A.
1st Academic Department of Dermatology, University of Athens Medical School, ‘A Sygros’ Hospital, Athens, Greece.

Background Topical immunotherapy with diphencyprone (DPCP) is considered the most effective treatment of alopecia areata (AA). Objective To assess the efficacy of DPCP in the treatment of extensive or long-lasting AA in Greek patients. Methods Sixty-four patients with extensive and/or long-lasting AA were sensitized with 2% diphencyprone. During each weekly subsequent visit, patients were treated with gradually denser concentrations adjusted in order to maintain erythema and itch on the patient's scalp for 48 h. Patients' hair re-growth was evaluated every 3 months for 2 years. Results Forty-five patients responded among the 54 completing therapy (83.3%). Initial response was observed 3.48 +/- 1.05 months after the initial treatment. Twenty patients among the responders achieved a grade 4 response, 15 patients achieved grade 3, 9 patients achieved grade 2, and 1 patient achieved a grade 1 response. The mean duration of treatment until maximum response was 6.14 +/- 1.48 months. Thirty-one patients (68.9%) had a relapse during follow-up and were treated again. The only adverse event among patients completing therapy was contact dermatitis of the face or neck (9 of 54) that resolved after topical corticosteroid application within 7 days. Statistical analysis did not establish any association among duration of AA, age, gender, atopic diathesis, nail involvement and presence of thyroid antibodies with response to treatment. Conclusion Treatment of Greek patients with AA with diphencyprone presents high response rates similar to those reported by previous studies. The treatment is adequately tolerated by most of the patients, and they are willing to repeat it in cases of relapse.

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J Am Acad Dermatol. 2007 Nov;57(5):767-74. Epub 2007 Aug 29.
A multicenter, randomized, placebo-controlled, double-blind clinical trial of a novel formulation of 5% minoxidil topical foam versus placebo in the treatment of androgenetic alopecia in men.
Olsen EA, Whiting D, Bergfeld W, Miller J, Hordinsky M, Wanser R, Zhang P, Kohut B.
Duke University Medical Center, Durham, North Carolina 27516, USA. olsen001@mc.duke.edu

BACKGROUND: An alternative to currently marketed topical minoxidil solutions is desirable. OBJECTIVE: To assess the efficacy and safety of a new 5% minoxidil topical formulation in a propylene glycol-free foam vehicle in men with androgenetic alopecia (AGA). METHODS: This was a 16-week, double-blind, placebo-controlled trial of 5% minoxidil topical foam (MTF) in 352 men, 18 to 49 years old. At week 16, 143 subjects continued on an open-label phase to collect 52 weeks of safety information on 5% MTF. RESULTS: At week 16 compared with baseline, there was a statistically significant increase in (1) hair counts in the 5% MTF group versus placebo (P < .0001) and (2) subjective assessment of improved hair loss condition (P < .0001) in the 5% MTF group versus placebo. The 5% MTF was well tolerated over a 52-week period. LIMITATIONS: There was no collection of efficacy data beyond 16 weeks. CONCLUSIONS: We believe that 5% MTF is a safe and effective treatment for men with AGA.

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J Am Acad Dermatol. 2007 Aug 28; [Epub ahead of print]
A multicenter, randomized, placebo-controlled, double-blind clinical trial of a novel formulation of 5% minoxidil topical foam versus placebo in the treatment of androgenetic alopecia in men.
Olsen EA, Whiting D, Bergfeld W, Miller J, Hordinsky M, Wanser R, Zhang P, Kohut B.
From Duke University Medical Center, Durham.

BACKGROUND: An alternative to currently marketed topical minoxidil solutions is desirable. OBJECTIVE: To assess the efficacy and safety of a new 5% minoxidil topical formulation in a propylene glycol-free foam vehicle in men with androgenetic alopecia (AGA). METHODS: This was a 16-week, double-blind, placebo-controlled trial of 5% minoxidil topical foam (MTF) in 352 men, 18 to 49 years old. At week 16, 143 subjects continued on an open-label phase to collect 52 weeks of safety information on 5% MTF. RESULTS: At week 16 compared with baseline, there was a statistically significant increase in (1) hair counts in the 5% MTF group versus placebo (P < .0001) and (2) subjective assessment of improved hair loss condition (P < .0001) in the 5% MTF group versus placebo. The 5% MTF was well tolerated over a 52-week period. LIMITATIONS: There was no collection of efficacy data beyond 16 weeks. CONCLUSIONS: We believe that 5% MTF is a safe and effective treatment for men with AGA.

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Rev Stomatol Chir Maxillofac. 2007 Jun 15; [Epub ahead of print]
[18 cases of cicatricial alopecia treated by tissue expansion.]
[Article in French]
Drissi Qeytoni H, Nassih M, Rzin A, Jidal B.
Service de chirurgie plastique, chirurgie maxillofaciale et stomatologie, hôpital militaire d'instruction Mohamed-V, BP 10100, Rabat, Maroc.

INTRODUCTION: Skin expansion technique used to increase the hair surface available at the scalp level was a major breakthrough in the surgical treatment of important cicatricial alopecia. This article had for aim to define the importance and limits of this technique in the treatment of alopecia and to highlight its relevance compared to other methods. PATIENTS AND METHODS: Between November 1998 and April 2006, 18 patients (7 women and 11 men) presenting with one or many cicatricial alopecia areas were treated by skin expansion. The age of patients ranged between 14 and 68 years, with an average of 33 years. The indications were related to burn sequels in 44% of all cases. The average area of alopecia was 167 cm(2). This technique combines two operating phases. In the first phase, the expansion balloon is inserted and then gradually filled. In the second phase, it is removed and the alopecic area is covered by the expanded flaps. RESULTS: Thirty-nine expansion prostheses were used, with an average volume of 292 cc. Their number varied between 1 and 6 (two on average) for each patient. The average duration of expansion was 77 days. The tissue gained with this technique allowed the use of 38 flaps. The transposition flaps was the most frequently used (39.4%). The rate of major complications leading to total failure of the process reached 5.5%. The final result was considered good in 90% of the cases. DISCUSSION: The results demonstrate that skin expansion technique is a simple, reliable, and efficient method in the healing of important cicatricial alopecia of scalp. It enables a wider use of the classical local flap technique, by expanding the surface and vascularization allowing for a direct suturing of the donor site. Skin expansion holds an important place in the treatment of significant skin cicatricial alopecia, since it represents the only surgical solution when the alopecia area exceeds 50 cm(2).

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Endocrinol Metab Clin North Am. 2007 Jun;36(2):379-98.
Androgenetic alopecia.
Otberg N, Finner AM, Shapiro J.
Department of Dermatology and Skin Science, University of British Columbia, 835 West 10th Avenue, Vancouver, BC V5Z 4E8, Canada.

Androgenetic alopecia (AGA), or male pattern hair loss, affects approximately 50% of the male population. AGA is an androgen-related condition in genetically predisposed individuals. There is no treatment to completely reverse AGA in advanced stages, but with medical treatment (eg, finasteride, minoxidil, or a combination of both), the progression can be arrested and partly reversed in the majority of patients who have mild to moderate AGA. Combination with hair restoration surgery leads to best results in suitable candidates. Physicians who specialize in male health issues should be familiar with this common condition and all the available approved treatment options.

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J Dtsch Dermatol Ges. 2007 May;5(5):391-5.
Comparison of the efficacy and safety of topical minoxidil and topical alfatradiol in the treatment of androgenetic alopecia in women.
[Article in English, German]
Blume-Peytavi U, Kunte C, Krisp A, Bartels NG, Ellwanger U, Hoffmann R.
Department of Dermatology and Allergy, Charite- Medical University, Berlin, Germany. ulrike.blume-peytavi@charite.de

BACKGROUND: Two drugs which are approved for the treatment of androgenetic alopecia in women in Germany were compared with regard to their influence on hair growth. PATIENTS AND METHODS: Patients were randomized to group I (n = 52) who used 2% minoxidil solution twice daily for a period of 12 months or to group II (n = 51) who used 0.025% alfatradiol solution once daily for 6 months and were then switched to 2% minoxidil solution for months 7-12. Changes in hair growth parameters were determined using the TrichoScan. RESULTS:Topical treatment with 2% minoxidil solution for 6 months resulted in a significant increase of cumulative hair thickness (p < 0.0001) and absolute hair density (p < or = 0.0025), whereas these parameters of hair growth remained nearly unchanged after 6 months of treatment with alfatradiol solution. Evaluation of the same parameters from month 7 to month 12 demonstrated that 12 months minoxidil treatment resulted in an increasing stabilization (group I). After the alfatradiol-->minoxidil switch in group II a significant increase in cumulative hair thickness (p < 0.0001) and absolute hair density (p < 0.0001) was achieved. Both study medications were well tolerated. CONCLUSIONS: Treatment with minoxidil can induce an increase in hair density and hair thickness,whereas treatment with alfatradiol results in deceleration or stabilization of hair loss.

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J Am Acad Dermatol. 2007 Apr 27; [Epub ahead of print]
A case-series of 29 patients with lichen planopilaris: The Cleveland Clinic Foundation experience on evaluation, diagnosis, and treatment.
Cevasco NC, Bergfeld WF, Remzi BK, Ramirez de Knott H.
>From the Departments of Dermatology.

BACKGROUND: Lichen planopilaris results in scaling, atrophy, and permanent alopecia with scarring and is thought to be autoimmune in origin. OBJECTIVE: To evaluate the clinical findings of patients with LPP so as to aid in the evaluation and diagnosis of the disease and to review the current effective therapies. METHODS: We reviewed the medical records of 29 patients with LPP that were seen in the Department of Dermatology at The Cleveland Clinic Foundation between 1992 and 2003. RESULTS: Good responses in the active perimeter were seen with topical steroids, intralesional steroids, and tetracycline and in the inactive end-stage with hair transplants and scalp reductions. LIMITATIONS: This study was limited by being retrospective in nature. CONCLUSION: Although topical high-potency and intralesional corticosteroids remain the mainstay for treatment of LPP, the use of tetracycline in this disease may be more helpful than once thought.

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J Cosmet Laser Ther. 2007 Mar;9(1):27-8.
The current role of laser/light sources in the treatment of male and female pattern hair loss.
Avram MR, Leonard RT Jr, Epstein ES, Williams JL, Bauman AJ.
NY Presbyterian/Weill Cornell Medical Center. New York, NY. USA.

Over the past several years there has been great interest in the potential role of laser/light-based treatments for male and female pattern hair loss. Despite aggressive marketing and centers claiming great success in the treatment of hair loss there is little scientific data supporting laser/light sources in hair loss. This paper is a consensus of hair loss experts on the current scientific data, mechanisms of action, safety, protocols and recommendations regarding laser/light treatment for hair loss. The authors believe that, while seemingly safe, there are no controlled, peer-reviewed studies validating current devices for hair loss and that all patients should be medically evaluated for any hair loss by a physician specialist to rule out other underlying medical conditions or the etiology of hair loss.

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Gynecol Endocrinol. 2007 Mar;23(3):142-5.
Effect of finasteride 5 mg (Proscar) on acne and alopecia in female patients with normal serum levels of free testosterone.
Kohler C, Tschumi K, Bodmer C, Schneiter M, Birkhaeuser M.
Division of Gynaecological Endocrinology and Reproductive Medicine, Department Ob/Gyn, University of Berne. Berne. Switzerland.

Background. In some women with acne or alopecia who have normal serum levels of free testosterone, no clinical improvement can be reached by the classical treatment with antiandrogens, isotretinoids or corticosteroids. Our hypothesis is that some of these women have an excessive activity of the enzyme 5alpha-reductase. Objective. To evaluate the subjective benefit of the treatment with finasteride (5 mg/day) in women with normal serum levels of free testosterone suffering from acne or alopecia. Design. This was a retrospective study evaluating a questionnaire filled out by 12 patients, six of whom had acne and six of whom had alopecia. Results. Nine of the 12 patients benefited from the treatment, their symptoms decreased significantly and they felt better psychologically than before the administration of finasteride. The other three patients did not benefit at all from finasteride and reported no change in the extent of the acne/alopecia. Treatment was generally well tolerated, only a few adverse effects were noted. Conclusions. Nine of the 12 patients benefited from the treatment. This supports our hypothesis of an excessive activity of 5alpha-reductase enzyme in peripheral tissue in these patients. The fact that three of the patients did not realize any change in their symptom severity implies that there must also be other pathways in the genesis of acne and alopecia in women with normal levels of free testosterone. Further evaluation is needed to elucidate more precise indications for the administration of finasteride in women with acne and alopecia.

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J Cosmet Dermatol. 2007 Mar;6(1):9-13.
Dutasteride improves male pattern hair loss in a randomized study in identical twins.
Stough D.
The Dermatology Clinic, Hot Springs, AR 71913, USA. dowstoughmd@cablelynx.com

OBJECTIVES: This study compared the efficacy of dutasteride vs. placebo in the treatment of male pattern hair loss (androgenetic alopecia) in 17 pairs of identical twin males with androgenetic alopecia over a 1-year period. METHODS: In this randomized, double-blind, placebo-controlled, single-center study, one twin from each identical twin pair received dutasteride 0.5 mg/day for 12 months while the other received placebo for 12 months. Hair growth was evaluated using standardized clinical photographs, hair counts, and patient self-assessment questionnaires. RESULT: Dutasteride significantly improved hair growth at 1-year compared to placebo based on the analysis of the investigator assessment and the patient self-assessment questionnaires. Sixteen of 17 sets of twins completed the study, of which 15 sets correctly predicted the use of dutasteride. Only one set could not determine the active drug from the placebo. CONCLUSION: Through the use of identical twins, this randomized trial provides evidence that dutasteride significantly reduces hair loss progression in men with male pattern hair loss.

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Int J Dermatol. 2007 Feb;46(2):121-31.
Alopecia areata.
Wasserman D, Guzman-Sanchez DA, Scott K, McMichael A.
Department of Dermatology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, 27157, USA.

Alopecia areata (AA) is a nonscarring, autoimmune, inflammatory, hair loss on the scalp, and/or body. Etiology and pathogenesis are still unknown. The most common site affected is the scalp. Histopathology is characterized by an increased number of the catagen and telogen follicles, the presence of inflammatory lymphocytic infiltrate in the peribulbar region ("swarm of bees"). Corticosteroids are the most popular drugs for the treatment of this disease. Etiologic and pathogenic mechanisms, as well as other current treatments available will be discussed in this article.

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Dermatol Clin. 2007 Jan;25(1):101-9.
Photodynamic therapy: other uses.
Taub AF.
Department of Dermatology, Northwestern University Medical School, 676 St. Clair Street, Chicago, IL 60611, USA. drtaub@skinfo.com

Mainstream uses for photodynamic therapy (PDT) in dermatology include nonmelanoma skin cancer and its precursors, acne vulgaris, photorejuvenation, and hidradenitis suppurativa. Many other dermatologic entities have been treated with PDT, including psoriasis, lichen planus, lichen sclerosus, scleroderma, cutaneous T cell lymphoma, alopecia areata, verruca vulgaris, Darier's disease and tinea infections. Nondermatologic applications include anal and vulva carcinoma, palliation of metastatic breast cancer to skin, Barrett's esophagus, and macular degeneration of the retina. PDT also has found to be useful in immunologic and inflammatory disorders, neoplasias other than skin cancer, and infections. The ability of this treatment to hone in on dysplastic epithelial and endothelial cells while retaining viability of surrounding tissue is its key feature because this leads to specific tumor destruction with cosmesis and function of the target organ intact.

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J Am Acad Dermatol. 2006 Dec;55(6):1014-23.
The importance of dual 5alpha-reductase inhibition in the treatment of male pattern hair loss: results of a randomized placebo-controlled study of dutasteride versus finasteride.
Olsen EA, Hordinsky M, Whiting D, Stough D, Hobbs S, Ellis ML, Wilson T, Rittmaster RS; Dutasteride Alopecia Research Team.
Duke University Medical Center, Durham, North Carolina, USA. olsen001@mc.duke.edu

BACKGROUND: Male pattern hair loss (MPHL) is a potentially reversible condition in which dihydrotestosterone is an important etiologic factor. OBJECTIVE: Our aim was to evaluate the efficacy of the type 1 and 2 5alpha-reductase inhibitor dutasteride in men with MPHL. METHODS: Four hundred sixteen men, 21 to 45 years old, were randomized to receive dutasteride 0.05, 0.1, 0.5 or 2.5 mg, finasteride 5 mg, or placebo daily for 24 weeks. RESULTS: Dutasteride increased target area hair count versus placebo in a dose-dependent fashion and dutasteride 2.5 mg was superior to finasteride at 12 and 24 weeks. Expert panel photographic review and investigator assessment of hair growth confirmed these results. Scalp and serum dihydrotestosterone levels decreased, and testosterone levels increased, in a dose-dependent fashion with dutasteride. LIMITATIONS: The study was limited to 24 weeks. CONCLUSION: Dutasteride increases scalp hair growth in men with MPHL. Type 1 and type 2 5alpha-reductase may be important in the pathogenesis and treatment of MPHL.

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Cutis. 2006 Nov;78(5):333-6.
Helping children cope with hair loss.
Silverberg NB.
Department of Dermatology, St. Luke's-Roosevelt Hospital Center, 1090 Amsterdam Ave, Suite 11D, New York, NY 10025, USA. nsilverberg@juno.com

Alopecia totalis and alopecia universalis are emotionally devastating forms of hair loss, which are difficult to cure. When childhood hair loss is unresponsive to alopecia therapies, both traditional and nontraditional, children may be stigmatized and fall under extreme psychologic distress. The not-for-profit organization Locks of Love began providing custom hair prostheses to children in 1997 and has continued to serve the emotional and cosmetic needs of children with extensive hair loss.

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J Eur Acad Dermatol Venereol. 2006 Nov;20(10):1243-7.
Efficacy and safety of a new clobetasol propionate 0.05% foam in alopecia areata: a randomized, double-blind placebo-controlled trial.
Tosti A, Iorizzo M, Botta GL, Milani M.
Dermatology Clinic University of Bologna, Bologna, and R & D Mipharm, Milan, Italy.

BACKGROUND: Clinical efficacy of topical corticosteroids in alopecia areata (AA) is still controversial. Positive clinical results have been obtained using ointments with occlusive dressing but this approach has a low patient compliance. Recently, a new topical formulation (thermophobic foam: Versafoam) of clobetasol propionate 0.05% has been introduced on the market (Olux, Mipharm, Milan, Italy) (CF). This formulation is easy to apply. After application to the skin the foam quickly evaporates without residues and it has a good patient compliance. In vitro studies have also shown that this formulation enhances the delivery of the active compound through the skin. AIM: To evaluate the efficacy, safety and tolerability of CF in the treatment of moderate to severe AA. SUBJECTS AND METHODS: Thirty-four patients with moderate to severe AA (eight men, mean age 40+/-13 years) were enrolled in a randomized, double-blind, right-to-left, placebo-controlled, 24-week trial. Alopecia grading score (AGS) was calculated at baseline and after 12 and 24 weeks of treatment using a 0-5 score (0=no alopecia; 5=alopecia totalis). Clobetasol foam and the corresponding placebo foam (PF) were applied twice a day for 5 days/week for 12 weeks (phase 1) using an intrapatient design (right vs. left). From weeks 13 to 24 each enrolled patient continued only with the treatment (both on the right and left site) that was judged to have a greater efficacy than that on the contralateral side (phase 2). The primary outcome of the trial, evaluated on an intention-to-treat basis, was the hair regrowth rate, which was evaluated using a semiquantitative score (RGS) (from 0: no regrowth, to 4: regrowth of 75%). RESULTS: At baseline the AGS was 4.1 (range: 2-5). Nine (26%) patients prematurely concluded the trial. At the end of phase 1, a greater hair regrowth was observed in 89% of the head sites treated with CF vs. 11% in the sites treated with PF. The RGS was 1.2+/-1.6 in the CF-treated sites and 0.4+/-0.8 in the PF-treated sites (P=0.001). A RGS of 2 (hair regrowth of more than 25%) was observed in 42% CF-treated sites and in 13% of PF-treated sites (P=0.027). In seven subjects (20%) a RGS of 3 to 4 (hair regrowth of 50%) was observed in CF-treated sites. In three subjects (9%) a RGS of 4 (hair regrowth of 75%) was observed in CF-treated sites. In one patient only, in a PF-treated region, a RGS of 3 was observed. The AS was reduced to 3.8 by CF treatment at the end of phase 1 and to 3.3 at the end of phase 2 (P=0.01). From weeks 12 to 24 the treatment with CF induced a further increase in the RGS (from 1.2 to 1.5+/-1.4). Forty-seven per cent of CF-treated patients had a RGS of 2 at the end of the trial. A total of eight patients (25%) at the end of the treatment with CF showed a RGS of 3. Folliculitis occurred in two patients. No significant modifications in cortisol and ACTH blood levels were observed during the trial. CONCLUSION: This new formulation of clobetasol propionate foam is an effective, safe and well-tolerated topical treatment for AA. This formulation has a good cosmetic acceptance and patient compliance profile.

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J Am Acad Dermatol. 2006 Oct;55(4):632-6.
The use of methotrexate alone or in combination with low doses of oral corticosteroids in the treatment of alopecia totalis or universalis.
Joly P.
Department of Dermatology, Rouen University Hospital-Charles Nicolle, Rouen, France. Pascal.Joly@chu-rouen.fr

Treatment of severe alopecia areata (AA) remains difficult. To assess the tolerance and efficacy of methotrexate (MTX) in the treatment of severe long-term AA, we retrospectively evaluated 22 patients with AA totalis or universalis with a mean duration of 11.0 +/- 8.8 years who were treated with MTX either alone (n = 6) or associated with low doses of oral prednisone (n = 16). MTX was given at an initial weekly dosage of 15 mg (n = 3), 20 mg (n = 9), or 25 mg (n = 10). Oral prednisone was given at an initial dosage of 10 mg/d in one patient and 20 mg/d in 15 patients. In all, 14 patients (64%) achieved a total recovery including 3 of 6 patients treated by MTX alone and 11 of 16 who had received the combined treatment. Of the 14 patients who had total hair regrowth, 6 stopped MTX. In all, 3 patients maintained hair regrowth and 3 relapsed. Retreatment of these 3 patients by MTX resulted again in hair regrowth. No severe side effect was observed. Although limited by its uncontrolled character, this study shows that MTX and low doses of oral corticosteroids may be an effective and well-tolerated treatment for severe types of AA.

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J Int Med Res. 2006 Sep-Oct;34(5):514-9.
Nourkrin: objective and subjective effects and tolerability in persons with hair loss.
Thom E.
ETC Research and Development, Oslo, Norway. erlingthom@etc.as

This randomized, double-blind, placebo-controlled study was designed to investigate the efficacy and tolerability of Nourkrin, a new natural agent for the treatment of hair loss based on marine proteins, and minerals and vitamins. Fifty-five subjects with hair loss of different aetiologies participated in the 6-month blinded phase of the study. Objective assessments showed a significant positive effect of treatment on hair growth. Intake of the active preparation for a further 6 months in an open phase indicated a subjective further improvement in hair growth. Exposure of the patients previously treated with placebo to the active preparation for 12 months gave similar results. Tolerability was good and no side-effects were reported. Nourkrin may provide an alternative to pharmacotherapy for the treatment of hair-loss problems in individuals with androgenetic alopecia.
  
Previous Hair Loss Research: 2002-2006   
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