毛发老化

毛发老化包括毛干的剥蚀作用以及毛囊的老化。前者包括整个毛干纤维逐渐退化，后者表现为头发变白，或者头发生长缓慢。内在因素和外在因素均会导致毛发老化。外用抗毛发老化的药物包括护发素、光防护剂和抗氧化剂。染发是治疗灰发症的主要手段。目前用于治疗雄激素源性脱发的方法包括外用米诺地尔、口服非那雄胺以及自体毛发移植术。生物工程技术将在抗毛发老化方面发挥作用。     

毛发疾病

20100624雄激素性脱发发病机制的研究进展/李美红(天津中医药大学),徐丽敏∥中国麻风皮肤病杂志.-2009,25(2).-122～124雄激素性脱发(AGA)的病理变化机制还不完全清楚,毛囊单位的雄激素代谢是研究的重点和难点。雄激素-受体复合物对信号传导产生修饰作用,导致休止期毛囊向微型毛囊转变,从而引起雄激素源性脱发;5-α还原酶影响了头发毛囊局部雄激素代谢,因此也发挥了重要作用。研究也证实毛囊周围存在多种生长因子和受体,调控着毛发生长的周期。从遗传学角度研究发现位于雄激素受体基因上的X染色体是唯一的危险基因。此外对连环蛋白、角蛋白等的分子研究也证实它们在AGA中也发挥重要作用。由于A     

雄激素源性脱发的治疗进展

雄激素源性脱发(AGA)是常见的毛发脱失性疾病,好发于中年人,呈慢性进行性发展.表现为头顶部毛囊变小,生长期缩短,生长期/休止期毛囊比值下降,毛发直径变小,毳毛代替终毛,出现脱发.该病发生与遗传因素、雄激素代谢失常等因素有关.在治疗上有药物、物理治疗、手术等方法.     

头发直径的差异--一个反映毛囊变小的临床体征

目前评价雄激素源性脱发主要采用Hamilton、Ludwig和Savin等提出的临床综合分级法和其他较精确的技术方法。其中，毛发摄像图(phototrichogram)是公认的一种非创伤性技术，成为评价脱发程度和疗效的常规检查方法。该检查方法是以测定头发生长周期的持续时间和生长期／休止期毛囊比值为根据。     

5％米诺地尔酊治疗雄激素性脱发疗效观察

雄激素性脱发(androgenetic alopecia,AGA)是临床上最为常见的脱发性疾病,表现为额部发际逐渐后退,或顶部头发逐渐稀疏、脱落,头发密度进行性减少[1].AGA常用的治疗方法有口服非那雄胺、外用米诺地尔、联合治疗、毛发移植等.米诺地尔是一种非特异性促进毛发生长的药物,是美国食品和药物管理局批准的惟一男女均可使用的治疗AGA的外用药.常用浓度有2％、3％和5％.     

毛发疾病

20131789 ZMY-1型毛发移植系统治疗雄激素源性脱发的研究/王焱(中国医科院北京协和医学院皮研所),吴信峰,赵亮…//国际皮肤性病学杂志.-2013,39(4).-216~218选择40例雄激素源性脱发患者,予毛发移植术治疗,从打孔时间、出血量、打孔堵塞与否三个方面进行评估,探讨ZMY-1型毛发移植系统在毛发移植术受区打孔过程中的疗效及安全性。结果:机器打孔速度为(2.22±0.71)min/100孔,手工打孔速度为(11.33±2.68)min/100孔,机器打孔速度明显快于手工打孔速     

雄激素源性秃发的研究进展

1病名来源雄激素源性脱发(Androgenic Alopecia,简称AGA)是一种雄激素依赖性的遗传性毛发脱落病.过去又称寻常秃发(Common baldness)、早秃(Alopecia Prematura)或脂溢性脱发(Seborrheic Alopecia),以上病名沿用多年,直至1960年才由Orenlreich氏首先命名为AGA,因为本病的发生与遗传性素质和雄性激素有关[1].     

中国雄激素性秃发诊疗指南BASP分型法解读

正雄激素性秃发(androgenetic alopecia,AGA)是一种非瘢痕性秃发,发生于青春期和青春期后,主要表现为毛发进行性减少和毛囊的微小化。在男性主要表现为前额发际后移和/或头顶部毛发进行性减少和变细,也称为男性型脱发,在女性主要表现为头顶部毛发进行性减少和变细,少部分表现为弥漫性头发变稀,发际线不后移,称为女性型脱发。AGA是皮肤科的常见病、多发病,在我国男性的患病率为     

雄激素源性脱发的治疗学进展

雄激素源性脱发是最常见的一种脱发 ,其受多因素影响 ,病因复杂 ,治疗疗效不佳 ,对各种作用机制不同的药物、毛发移植、特制细胞培养基、脂质体毛囊传递系统及基因治疗等在治疗雄激素源性脱发中的应用、疗效及不良反应研究进展作了概括     

雄激素源性脱发的治疗学进展

雄激素源性脱发是最常见的一种脱发，其受多因素影响，病因复杂，治疗疗效不佳，对各种作用机制不同的药物、毛发移植、特制细胞培养基、脂质体毛囊传递系统及基因治疗等在治疗雄激素源性脱发中的应用、疗效及不良反应研究进展作了概括。     

Aging of hair

The appearance of hair plays an important role in people's overall physical appearance and self-perception. With today's increasing life expectation, the desire to look youthful plays a bigger role than ever. The hair care industry has become aware of this and also more capable to deliver active products that are directed toward meeting this consumer demand. The discovery of pharmacological targets and the development of safe and effective drugs also indicate strategies of the drug industry for maintenance of healthy and beautiful hair. Hair aging comprises weathering of the hair shaft and aging of the hair follicle. The latter manifests as decrease of melanocyte function or graying, and decrease in hair production in androgenetic and senescent alopecia. The scalp is also subject to intrinsic or physiologic aging and extrinsic aging caused by external factors. Intrinsic factors are related to individual genetic and epigenetic mechanisms with interindividual variation. Prototypes are familial premature graying and androgenetic alopecia. Extrinsic factors include ultraviolet radiation and smoking. Experimental evidence supports the hypothesis that oxidative stress plays a role in skin and hair aging. Topical anti-aging compounds for hair include humefactants, hair conditioners, photoprotectors, and antioxidants. Current available treatment modalities with proven efficacy for treatment of androgenetic alopecia are topical minoxidil, oral finasteride, and autologous hair transplantation. In the absence of another way to reverse hair graying, hair colorants are the mainstays of recovering lost hair color. Topical liposome targeting for melanins, genes, and proteins selectively to hair follicles are under current investigation.     

Histopathology of aging of the hair follicle

Hair follicles experience several changes with aging, the most noticeable of which is graying of the hair shaft due to loss of melanin. Additional changes in the diameter and length of the hair have contributed to the concept of senescent alopecia, which is different from androgenetic alopecia according to most. Graying happens in most individuals, although in different grades and starting at different ages. It is related to a decrease in the number and activity of the melanocytes of the hair bulb, which eventually completely disappear from the bulb of the white hair. Residual non‐active melanocytes remain in the outer root sheath and in the bulge, which allows for repigmentation of the hair under certain stimuli or conditions.     

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。     

The Pattern of Hair Dyeing in Koreans with Gray Hair

Background

Hair graying is considered as a part of normal ageing process. Nonetheless, this process raises a significant cosmetic concern, especially among ethnic Korean elderly whose baseline hair color is black. For this reason, Korean elderly dye their hair with frequency despite the risk of dermatologic problems such as allergic contact dermatitis.

Objective

In this study, the authors investigate the prevalence and pattern of hair dyeing and its relation with scalp diseases in Korea.

Methods

Six hundred twenty subjects (330 men and 290 women) with graying hair were given a questionnaire survery and underwent a physical examination.

Results

Of the 620 total, 272 subjects (43.9%) dyed their hair. Hair dyeing was significantly more frequent among women than among men (p<0.001). Subjects from 50 to 69 years of age showed higher prevalence of hair dyeing when compared to either younger or older groups. Subjective self-assessment of the extent of hair graying was associated with increased prevalence of hair dyeing, that is, individuals who feel graying has advanced by more than 20% of the overall hair were much more likely to dye their hair (p<0.001). Hair dyeing did not correlate with either alopecia or scalp disease.

Conclusion

Our survey has found that the prevalence of hair dyeing is higher among Korean women than men. People in their fifties and sixties and people with more than 20% extent of grayness were more likely to dye their hair than otherwise. Hair dyeing was not associated with any increase in the prevalence of scalp diseases.     

Female Pattern Hair Loss: a clinical and pathophysiological review

Female Pattern Hair Loss or female androgenetic alopecia is the main cause of hair loss in adult women and has a major impact on patients'' quality of life. It evolves from the progressive miniaturization of follicles that lead to a subsequent decrease of the hair density, leading to a non-scarring diffuse alopecia, with characteristic clinical, dermoscopic and histological patterns. In spite of the high frequency of the disease and the relevance of its psychological impact, its pathogenesis is not yet fully understood, being influenced by genetic, hormonal and environmental factors. In addition, response to treatment is variable. In this article, authors discuss the main clinical, epidemiological and pathophysiological aspects of female pattern hair loss.     

Acquired progressive kinking of the hair: clinical features, pathological study, and follow-up of 7 patients.

BACKGROUND: Acquired progressive kinking of the hair (APKH) is a relatively rare condition, with fewer than 20 cases reported in the literature. Whether APKH is a separate entity or a variety of androgenetic alopecia is still controversial. This study reviews the clinical and pathological features and long-term follow-up of 7 patients with APKH. OBSERVATIONS: Since January 1989, we have diagnosed APKH in 7 males aged 15 to 22 years. All patients had strong family history for androgenetic alopecia. Hair kinking affected the frontotemporal region and/or the vertex where the hair appeared curly, frizzy, and lusterless. The pathological features of the affected scalp were consistent with the diagnosis of the early stages of androgenetic alopecia. In all patients, APKH evolved into androgenetic alopecia during the follow-up period. Mean follow-up was 4.5 years (range, 2-9 years). Treatment with topical minoxidil did not prevent development of hair thinning in the scalp areas affected by hair kinking. CONCLUSIONS: The term acquired progressive kinking of the hair encompasses a number of conditions characterized by acquired curling of the scalp hair. Acquired hair kinking on the androgen-dependent areas of the scalp represents a modality of onset of androgenetic alopecia associated with poor prognosis.     

Trichostasis spinulosa of the scalp mimicking Alopecia Areata black dots

Alopecia areata is a common autoimmune disorder that leads to nonscarring hair loss. Black dots, also called comedo-like cadaver hairs, can be found in almost 50% of alopecia areata patients and indicate disease activity. Trichostasis spinulosa is a follicular disorder resulting from the retention of numerous hairs surrounded by a keratinous sheath in dilated follicles. Trichostasis spinulosa is a relatively common but underdiagnosed disorder of hair follicles. Here, we describe a man with alopecia areata of the eyebrows, androgenetic alopecia and trichostasis spinulosa at the vertex and show how dermoscopy can be useful in distinguishing black dots from Trichostasis spinulosa lesions.     

Hair restoration approaches for early onset male androgenetic alopecia

Society places great emphasis on the presence of hair. Some degree of hair loss is accepted as a normal part of the aging process, in line with the observation that more than 50% of men will develop androgenetic alopecia by the age of 50 years. However, it is possible to understand the psychosocial isolation and distress felt by men with a strong familial predisposition to androgenetic alopecia, who tend to display hair loss in their late teens or twenties. There are currently two drugs which have been licensed for the treatment of male androgenetic alopecia: oral finasteride and topical minoxidil solution which are effective to some extent. Furthermore, upon discontinuing treatment, any gain that has been achieved is quickly lost. Added to which there is an entire market of unproven over the counter products: advertised in the electronic media, local hair salons, and various departmental stores. In this review, we highlight the important advances in the management of male androgenetic alopecia with emphasis on approaches that can lead to more successful and long‐term hair restoration for young adults. In particular, we discuss the evidence supporting the use of the follicular unit grafting technique in conjunction with medical treatment before and after the procedure. Moreover, some other alterations of this most popular state of the art hair restoration technique have been mentioned briefly. As a result, patients and physicians seem equally satisfied from this procedure for its naturally looking results which are cosmetically more acceptable and esthetically pleasing for longer period of time.     

Topical fulvestrant solution has no effect on male and postmenopausal female androgenetic alopecia: results from two randomized, proof-of-concept studies

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.     

Three percent topical minoxidil therapy for female androgenetic alopecia

Effective treatment of female androgenetic alopecia involves cessation of hair shedding and promotion of normal anagen hair growth. The topical use of hormones such as progesterone or an androgen receptor-binding drug such as spironolactone has not been associated with significant hair regrowth.¹ In contrast, the topical use of minoxidil has resulted in decreased hair shedding and hair growth promotion, particularly in men with androgenetic alopecia.² To investigate the usefulness of topical minoxidil therapy in female androgenetic alopecia, we studied the efficacy and safety of 3% topical minoxidil in 25 affected women. Results were correlated with disease extent and activity.