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At least 19 recordsLinked to original sources
PubMed2003

Molecular mechanisms of chemotherapy-induced hair loss.

Hair loss (alopecia) is a much-feared side-effect of many chemotherapy protocols and is one of the most psychological devastating aspects of cancer therapy. So far, no satisfactory strategy for suppressing chemotherapy-induced alopecia is at hand. During the last decade, some progress in understanding molecular mechanisms of chemotherapy-induced hair loss has been achieved using rodent models. However, the pathobiology of the response of human hair follicle to chemotherapy remains largely unknown. Here, we review molecular mechanisms that control apoptosis in the hair follicle induced by chemotherapy and delineate the basic strategy for pharmacological inhibition of this devastating side-effect of cancer treatment. We focus on the roles of p53 and its target genes that are essential in mediating responses of hair follicle cells. We assume that local pharmacological inhibition of p53 activity may serve as an effective treatment to prevent chemotherapy-induced hair loss. Sufficient pharmacological inhibition of chemotherapy-induced hair loss may require a combination of inhibitors to block complementary or redundant pathways of apoptosis in hair follicles.

Alopecia↗
PubMed2003

[Hair loss].

Hair loss includes excessive shedding of hair (effluvium) and the alopecias, in which there is a decrease in the amount of hair. Both may occur diffusely, or in a circumscribed manner. The localization and pattern of circumscribed hair loss may give a clue to its cause. On the basis of morphologic criteria the alopecias are further classified into non-scarring and scarring types. Non-scarring alopecias (diffuse alopecia, androgenetic alopecia, alopecia areata) are essentially hair cycling disorders, while scarring alopecias result from irreversible destruction of the hair follicles with recognizable loss of follicular osita. Scalp biopsy should be an early step in the evaluation of any case of alopecia, in which scarring is suspected. Too little scalp hair is not a vital problem, but represents a major health care challenge. Only recently the psychological impact of hair loss has been appreciated by the medical community, though throughout history, too little hair has been a concern to mankind, and the object of cosmetic interest and quackery. Recent advances of the medical sciences have led to a better understanding of the underlying pathogenic processes and opened the venue to effective pharmacotherapy (minoxidil, finasteride) and technologies (autologous hair transplantation) for the treatment of the most common disorders. Together with the availability of such treatments, high technical standards for evaluating their efficacy have been developed and have become mandatory for appraisal of any hair growth promoting agent, both in clinical studies and in the individual patient.

Adult↗
PubMed2003

Phototrichogram analysis of Japanese female subjects with chronic diffuse hair loss.

Hair growth patterns of 101 Japanese female subjects with diffuse, chronic hair loss and 58 healthy Japanese female volunteers were categorized into subgroups using noninvasive quantitative methods after determining the key parameters of hair growth. Phototrichogram was performed at 0 and 48 h after clipping hairs in the parietal region of the scalp. Shaft diameters of the excised hairs were then measured. Multiple regression analysis indicated that hair densities, hair diameters, short hair ratios, and hair growth rates, but not anagen hair ratios, were significant, in order of decreasing importance, for grading female diffuse alopecia. Using cluster analysis, hair growth patterns among subjects complaining of diffuse hair loss were divided into six abnormal groups (n=60), two borderline groups (n=21), and one normal group (n=20). The control subjects judged to be normal by macroscopic observation, actually included two subjects with borderline hair growth patterns and one abnormal subject. Most of the abnormal groups shared features of female androgenetic alopecia. Hair patterns showing a decrease in hair density but without vellus hair change, however, emerged as the most prevalent and distinct pattern of chronic diffuse hair loss among the Japanese female subjects. The phototrichogram, combined with the measurement of hair diameters, is an accurate tool for assessing hair growth patterns, especially in detecting the slight changes indicative of the early phase of diffuse alopecia.

Adolescent↗
PubMed1994

Drug-induced hair loss and hair growth. Incidence, management and avoidance.

A large number of drugs may interfere with the hair cycle and produce hair loss. Drugs may affect anagen follicles through 2 main different modalities: (i) by inducing an abrupt cessation of mitotic activity in rapidly dividing hair matrix cells (anagen effluvium) or (ii) by precipitating the follicles into premature rest (telogen effluvium). In anagen effluvium, hair loss usually occurs within days to weeks of drug administration, whereas in telogen effluvium, hair loss becomes evident 2 to 4 months after starting treatment. Anagen effluvium is a prominent adverse effect of antineoplastic agents, which cause acute damage of rapidly dividing hair matrix cells. Telogen effluvium may be a consequence of a large number of drugs including anticoagulants, retinol (vitamin A) and its derivatives, interferons and antihyperlipidaemic drugs. Drug-induced hair loss is usually reversible after interruption of treatment. The prevalence and severity of alopecia depend on the drug as well as on individual predisposition. Some drugs produce hair loss in most patients receiving appropriate dosages while other drugs are only occasionally responsible for hair abnormalities. Both hirsutism and hypertrichosis may be associated with drug administration. Drugs most commonly responsible for the development of hirsutism include testosterone, danazol, corticotrophin (ACTH), metyrapone, anabolic steroids and glucocorticoids. Hypertrichosis is a common adverse effect of cyclosporin, minoxidil and diazoxide.

Alopecia↗
PubMed2000

[Interrelations between physician, hairdresser and mass media in management of hair loss].

Hair problems are attacked at the levels of information supply, trichological competence and evidence based medical treatment. The alopecias represent a major health care challenge, and the psychological significance of hair loss has only recently found appreciation in the medical community. They may pose a vexing problem for non-specialized physicians, who tend to trivialize such complaints, although the patient's perception of abnormality determines whether or not advice is sought. Perception of a hair problem is subject to sociocultural standards; films and advertisements help determine the threshold for "normality" and what is "healthy" and "beautiful", and the media provide an abundance of undiscriminating information with respect to hair care. Patients with hair problems frequently consult the hairdresser prior to the medical specialist. Thus additional areas of competence should be incorporated into the hairdresser's training qualifications. Besides manual, creative and psychological aptitudes, "trichological competence" relating to the recognition of most important hair disorders, recognition of personal limitations and cooperation with the medical specialist are required. To optimize the interaction between the physician, hairdressers and the media, more effective communication and public activities from the medical profession are desirable, with success depending on full identification of the set goals, qualification and adherence to the standards determined by the medical speciality.

Alopecia↗
PubMed2006

Validation of scalp coverage scoring methods for scalp hair loss in male pattern hair loss (androgenetic alopecia).

BACKGROUND: Global evaluation of hair loss in male subjects affected by androgenetic alopecia has been proposed as a means for monitoring changes over time, including placebo-controlled drug efficacy studies. Because of the potential impact of subjectivity (e.g. placebo effect) of clinical investigators, global photographs (GPs) have been introduced as a more objective record. Examination of paired before and after pictures and rating on a seven-point scale (from greatly decreased -3 to greatly increased +3) have been historically introduced by United States of America (US) experts. METHODS: Based on published GPs and original GPs obtained at our clinical research facility, we developed a training set in order to allow European Union (EU) observers to practice and compare with ratings by the US experts. RESULTS: After training with the seven-point scale, there was a positive correlation between three US and three EU ratings (n=52 paired images from 35 different subjects, r=0.795). The results of a test-retest evaluation was performed on 18 paired images from the initial image collection by the three EU experts. Correlation r=0.806 and identical scores in 78% of cases documents a reproducibility similar to the single one US expert published data (119 subjects, retest correlation 0.76 with 75% identical duplicate ratings). Seventeen subjects taken from a placebo-controlled trial had GPs at 6 and 12 months. The average difference between an efficacious drug treatment and the placebo were almost similar in the US (0.833) as in the EU (0.689) expert panels. We also trained the EU experts in performing the scalp coverage scoring (SCS), a novel system for the global evaluation of scalp hair in vivo and on GP. SCS was performed on single images (randomised as to time and treatment) taken from the same set of 17 paired GPs. This showed a between-group difference of 0.055 at 6 months and 0.201 at 12 months, i.e. 5% improved coverage in favour of the active group. CONCLUSION: After completion of our study, US and trained - calibrated EU experts seem equally valuable in comparing before-after GPs. SCS can also be used on GPs and may support the clinical investigator during inclusion of test subjects and for real-time efficacy evaluation during the trial.

Alopecia↗
PubMed2004

Women who present with female pattern hair loss tend to underestimate the severity of their hair loss.

BACKGROUND: Female pattern hair loss (FPHL) is the preferred term for androgenetic alopecia in women. FPHL can be a source of considerable distress for affected women. Our hypothesis was that women with FPHL who seek treatment would rate their condition as more severe than would their treating doctors. OBJECTIVES: To identify discrepancies between the severity ratings of the women and their clinicians. METHODS: Participants were 30 women receiving treatment for biopsy-proven FPHL and 44 women on a waiting list to receive treatment for FPHL. Each woman completed a self-report photographic measure of severity of hair loss, specifically developed for the current study. RESULTS: Although no difference was found between the severity ratings of women receiving treatment and their clinicians, it was found that women in the waiting list group underestimated the severity of their hair loss compared with their clinicians' ratings. CONCLUSION: The results indicate that FPHL-affected women who seek treatment for FPHL do not overestimate the severity of the hair loss; in fact, they tend to underestimate. The present findings have implications for the treatment of FPHL.

Adult↗
PubMed2002

Cosmetics and hair loss.

Cosmetic hair care products are often implicated by the user or the clinician in cases of hair loss. Yet, these products are used ad lib, in a wide variety of home conditions and on a wide variety of hair types, by millions of consumers every day with no adverse effects. Based on this extensive data set, the absence of literature reports, and a detailed understanding of the mode of action of cosmetic hair care products, we can conclude that they do not cause hair loss. Clinicians investigating cases of hair loss must fully appreciate the hair cycle, the length of time a single fibre may be present on the head, and its biological and cosmetic history in order to understand the causes of hair loss and make the correct diagnosis. With a better understanding of the cosmetic practices used by everyday consumers, the clinician will be in a strong position to help patients re-grow their hair and guide them through a high quality hair care regime.

Alopecia↗
PubMed2003

Common hair loss disorders.

Hair loss (alopecia) affects men and women of all ages and often significantly affects social and psychologic well-being. Although alopecia has several causes, a careful history, dose attention to the appearance of the hair loss, and a few simple studies can quickly narrow the potential diagnoses. Androgenetic alopecia, one of the most common forms of hair loss, usually has a specific pattern of temporal-frontal loss in men and central thinning in women. The U.S. Food and Drug Administration has approved topical minoxidil to treat men and women, with the addition of finasteride for men. Telogen effluvium is characterized by the loss of "handfuls" of hair, often following emotional or physical stressors. Alopecia areata, trichotillomania, traction alopecia, and tinea capitis have unique features on examination that aid in diagnosis. Treatment for these disorders and telogen effluvium focuses on resolution of the underlying cause.

Alopecia↗
PubMed2005

Hair loss: is there a relationship with hair care practices in Nigeria?

BACKGROUND Hair loss occurs in all ethnic populations, but the etiology varies considerably from group to group. In black women, many forms of alopecia are associated with hair care practices. However, the causes of alopecias in African women have not been extensively investigated. OBJECTIVE This descriptive, cross-sectional, hospital-based study was undertaken to document common complaints on initial presentation for hair loss, hair care practices and patterns of hair loss, and to determine if there is a relationship between hair loss and hair care practices. METHODS A total of 39 female patients seen over a 12 month period were enrolled in the study. Demographic information recorded included age, sex, marital status and occupation. Information regarding medical history included initial presenting complaints, duration of hair loss, site of hair loss, whether there was skin or systemic involvement, hair care practices and the duration of these practices. Examination of the scalp, a hair-pull test, documentation of the pattern of hair loss, relevant laboratory tests and biopsies were carried out. RESULTS All 39 patients were adults. Major complaints at initial presentation, apart from hair loss, included itchy scalp in 17 patients (43.6%), painful scalp in 11 patients (28.2%), hair breakage in seven patients (17.9%) and flaking scalp in four patients (10.3%). All the women relaxed their hair at some point in time. Chemical relaxants were consistently used by 22 patients (53.7%), eight patients (20.5%) alternated these with plaits/braids, and nine patients (23.1%) wore extensions. The use of local concoctions in hair care management was reported by three patients (7.7%). Scarred alopecias were observed in 20 patients (51.3%), while 19 (48.7%) had non-scarred alopecias. Those who reported prolonged and frequent use of chemical relaxants [mean duration (+/- standard deviation) 23.2+/-9.3 years] exhibited scarred alopecia more commonly than those who did not often use chemical relaxants (P<0.001). The application of local concoctions or pomades was also a regular practice amongst females with scarred alopecias. CONCLUSIONS Itchiness, pain, ready hair breakage and flaking scalp were common complaints at initial presentation. A range of alopecias were documented, and it was also observed that duration of hair care practice and hair styling were relevant to hair loss, particularly for women with central centifugal cicatricial alopecias (CCCAs), which resulted in scarring.

Adolescent↗
PubMed2006

Female patients complaining about hair loss: documentation of defective scalp hair dynamics with contrast-enhanced phototrichogram.

BACKGROUND: The complaint of chronic hair loss frequently affects female subjects and there is little or no objective technology available in the general dermatology or even in the hair clinics to guide the observer in the management of the patient. The purpose of this report is to share the results of refined hair growth measurements that were collected in 92 female subjects complaining about hair loss. METHODS: Clinically they were classified as having a patterned hair loss according to Ludwig (L; n=50), diffuse hair loss (D; n=13) or no visible hair loss but complaining of hair shedding (N; n=29). Two scalp sites on the top of the head and one occipital site were investigated after clipping by close-up photography before and after a hair dye (contrast enhancement, CE). Forty-eight hours later a new photograph was taken after CE in view of phototrichogram analysis (CE-PTG). Finally a last hair clip was performed 30 days later and hair thickness and length determined for linear growth measurements (LHGR). RESULTS: Herein we confirm that the top of the head shows usually a higher hair density than occipital sites, a physiological observation that applies both to men and women. From the technological perspective, we also document that CE improves hair detection in all sites. Interestingly, in affected patients (L and D) the relative increase of hair counts after CE was much higher (range +22.4% to +28.3%) compared with apparently unaffected females (N; range +8.2% to +9.7%). This increase in hair counts was only due in part to the presence of less pigmented thinning hair (thickness less than 40 microm). Such thin hairs were found in statistically significantly higher proportions in younger patients with mildly severe (grade I) patterned alopecia (Ludwig: L). In other patients with hair loss and in more severe forms of patterned alopecia - especially in older patients - the thin hair is not detected in abnormal proportions. In all sites slower growth rates and decreased anagen percentages indicate a defective hair replacement programme distinguishing L patterns from diffuse hair loss and from apparently unaffected patients complaining of chronic hair loss. Globally, we also noted that increasing age is associated with significant regression of scalp hair (decreased hair counts, thinner hair and slower LHGR). CONCLUSION: On the basis of the present data together with female data from the literature and our own studies in male subjects, we suggest a three-step mechanism leading to hair loss 1. Shortening of growth phase the hair cycle with maintained thick hair, i.e. more frequent hair cycling that leads to more hair shedding. 2. Intermittent production of short thin hair, i.e. morphological evidence of miniaturisation. 3. Very occasional or almost no hair production, i.e. dormant follicles or irreversible follicular atrophy. Depending on the genetic background, hormonal microenvironment in the scalp and conditioning of individual hair follicle bio-responses, female and male patterned hair loss may end up into different phenotypes.

Alopecia↗
PubMed2003

Toe tourniquet syndrome in association with maternal hair loss.

Increased hair loss a few months after delivering an infant is a common postpartum condition known as telogen effluvium. A much less common condition involving young infants is the hair-thread tourniquet syndrome, or toe tourniquet syndrome, which involves hair or thread becoming so tightly wrapped around an appendage that pain, injury, and sometimes loss of the appendage result. This case report is the first known description of the hair-thread tourniquet syndrome in association with maternal telogen effluvium. A literature review shows that accidental cases involving human hair almost always involve the toes, and usually occur at the age when mothers are experiencing excessive hair loss. This association is significant in that anticipatory guidance of new parents experiencing rapid hair loss may prevent cases of the toe tourniquet syndrome and its associated morbidity.

Female↗
PubMed1997

Hair loss after routine immunizations.

CONTEXT: Alopecia is a recognized adverse effect of numerous medications, but vaccines are not normally considered a cause for unexpected loss of hair. OBJECTIVE: To describe case reports of hair loss after routine vaccines and to assess the hypothesis that vaccinations might induce hair loss. DESIGN: Case series with telephone follow-up. METHODS: Review of spontaneous reports to the Food and Drug Administration, the Centers for Disease Control and Prevention, and the Vaccine Adverse Event Reporting System. MAIN OUTCOME MEASURE: Loss of hair following immunization. RESULTS: A total of 60 evaluable reports submitted since 1984 and coded for "alopecia" after immunizations included 16 with positive rechallenge (hair loss after vaccination on more than 1 occasion), 4 of which were definite and 12 possible or probable. Of the 60 cases, 46 had received hepatitis B vaccines. Both of the currently available recombinant products, as well as the former plasma-derived product, were represented. Females predominated in all age groups. The majority of patients recovered, but clinical features, such as intervals from vaccination until onset and the extent and reversibility of hair loss, varied widely. Nine patients reported previous medication allergy. CONCLUSION: There may be an association, probably very rare, between vaccinations and hair loss. More than 1 pathophysiologic mechanism may be responsible. Since apparently nonrandom distributions by vaccine, age, and sex could reflect biased case ascertainment, further research will be needed in defined populations with consistent case detection.

Adult↗
PubMed1987

Doxorubicin-induced hair loss in the Angora rabbit: a study of treatments to protect against the hair loss.

An animal model for anticancer drug-induced hair loss has been developed using the Angora rabbit given i.v. doxorubicin, 2 mg/kg, twice weekly for 3 weeks. There was a 167% increase in the weight of hair collected by grooming between weeks 2 and 5, and a 72% inhibition of new hair growth at week 6 compared with non-treated animals. The hairs that grew in the doxorubicin treated rabbits did so at the same rate as in non-treated rabbits and appeared normal by light microscopy. Topical application of dimethylsulfoxide (DMSO), of 10% alpha-tocopherol in DMSO, of 0.5% naphthazoline hydrochloride in DMSO, of 0.1% fluocinolone acetonide in a propylene glycol base and local hypothermia did not provide any protection against doxorubicin-induced hair loss. Angora rabbits fed an alpha-tocopherol-deficient diet for 6 weeks showed decreased hair growth compared with animals fed a normal diet or a diet supplemented with 100 mg alpha-tocopherol acetate twice a week for 6 weeks. Some rabbits fed the alpha-tocopherol-deficient diet died when given doxorubicin. Rabbits fed the alpha-tocopherol-supplemented diet showed evidence of protection against doxorubicin-dependent inhibition of new hair growth.

Alopecia↗
PubMed2002

Female pattern hair loss.

Female pattern hair loss is a common condition characterized by a diffuse reduction in hair density over the crown and frontal scalp with retention of the frontal hairline. The prevalence increases with advancing age. It has been widely thought to be the female counterpart of male balding and is often referred to as female androgenetic alopecia. However, the role of androgens is not fully established. Scalp hair loss is undoubtedly a feature of hyperandrogenism in women but many women with female pattern hair loss have no other clinical or biochemical evidence of androgen excess. Female pattern hair loss is probably a multifactorial genetically determined trait and it is possible that both androgen-dependent and androgen-independent mechanisms contribute to the phenotype. In managing patients with female pattern hair loss the physician should be aware that the adverse effects on quality of life can be quite severe and do not necessarily correlate with the objective degree of hair loss. The treatment options are currently limited but modest improvements in hair density are achievable in some women.

Alopecia↗
PubMed2001

Hair density, hair diameter and the prevalence of female pattern hair loss.

BACKGROUND: Female pattern hair loss is common but estimates of its prevalence have varied widely. The relationships between the clinical diagnosis of female pattern hair loss and objective measurements of hair density and hair diameter have not previously been evaluated. OBJECTIVES: To determine the prevalence of female pattern hair loss and to relate the clinical findings to hair density and hair diameter. METHODS: We examined 377 women, aged 18--99 years, who presented to a general dermatology clinic with complaints unrelated to hair growth (the unselected sample). A second group of 47 women referred with typical female pattern hair loss was included in analyses of the relationships between hair density, hair diameter and the clinical diagnosis. Hair density was measured using a photographic method. In each subject the major and minor axis diameters were measured in a random sample of 50 hairs. RESULTS: Six per cent of women aged under 50 years were diagnosed as having female pattern hair loss, increasing to 38% in subjects aged 70 years and over. The mean +/- SEM hair density was 293 +/- 61.3 hairs cm(-2) at age 35 years, falling to 211 +/- 55.1 hairs cm(-2) at age 70 years. Hair density showed a normal distribution in the unselected sample. Most women classified as having female pattern hair loss had hair densities within the lower half of the normal distribution. The perception of hair loss was determined mainly by low hair density (ANOVA P < 0.001), but there was overlap in hair density between women classified as having Ludwig I hair loss and the no hair loss group, which was partly accounted for by differences in mean hair diameter (ANOVA P < 0.001). Low hair density was associated with fewer hairs of all diameters. CONCLUSIONS: Hair density in women is distributed as a normal variable, indicating that it is determined as a multifactorial trait. Women with female pattern hair loss have a hair density which falls below the mean but lies within the spectrum of the normal distribution, although other factors, including hair diameter, may affect the subjective impression of hair loss. The hair diameter data suggest that low hair density is not due to progressive diminution in hair follicle size and that follicular miniaturization may occur within the space of a single hair cycle.

Adolescent↗