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Platelet-rich plasma (PRP) therapy has been considered as a promising treatment for androgenetic alopecia (AGA). The aim of the study was comparative evaluation of the clinical efficacy of PRP-therapy, minoxidil, and their combination in the treatment of men with AGA and to evaluate the effects of PRP on the proliferation of hair follicle (HF) cells in skin biopsy. Materials and Methods: The study involved 69 men who were divided into 3 groups who received PRP therapy, minoxidil, and their combination. The clinical efficacy of the therapy was evaluated by the dynamics of morphometric of hairs. To assess cell proliferation antibodies to β-catenin, CD34, Ki67, and to Dkk-1 were used. Results. PRP treatment was more effective than minoxidil therapy (p = 0.005). Complex therapy turned out to be more effective than minoxidil monotherapy (p < 0.0001) and PRP monotherapy (p = 0.007). After applying PRP the absolute and relative values of the β-catenin and CD34 expression area increased; an increase in Ki67+ index was also significant. Conclusions: PRP can be considered as a treatment option for AGA. Combined PRP and minoxidil use seems promising for the treatment of AGA. PRP increase in the proliferative activity of HF cells and improves hair morphology in patients with AGA.

Hair bio-engineering has risen at the crossing point of various manipulations to meet a clinical requirement for innovations to advance hair growth. The authors reported the microscopic and trichoscopic results of an autologous cell biological technique to compare, through histological, immunocytochemistry, and cytospin analysis, hair re-growth obtained by micro-grafts from scalp tissue containing Human Intra- and Extra-Dermal Adipose Tissue-Derived Hair Follicle Stem Cells (HD-AFSCs) versus placebo (saline solution). An autologous solution of micro-grafts was obtained from mechanical fragmentation and centrifugation of scalp biopsy’s (2 × 2 mm) using “Gentile protocol”. The micro-grafts solution was mechanically infiltrated on half of the selected patients’ scalps with Androgenic Alopecia (Norwood–Hamilton 2–5 and Ludwig 1–2). The other half was infiltrated with saline solution. Three injections were performed to each patient at 45-day intervals. Of the 35 patients who were enrolled, 1 was excluded and 1 was rejected. 23 and 44 weeks after the last micro graft’s injections, the patients displayed a hair density improvement, with a mean increment of 33% ± 7.5% and 27% ± 3.5% respectively, contrasted with baseline values, for the treated region. Microscopic assessment appeared, in scalp biopsies, to show an expansion in the number of hair follicles per mm2 following 11 months from the last micro-grafts application compared with baseline (1.4 + 0.27 versus 0.46 + 0.15, respectively; p < 0.05). HD-AFSCs contained in micro-grafts may represent a safe and effective alternative therapy option against hair loss.

The aim of this study is to analyze treatment adherence and its influencing factors in patients with androgenetic alopecia (AGA). Clinical data from 156 AGA patients, including 89 males and 67 females, were collected. The patients were assigned to either medication group ( n  = 86) or microneedling group ( n  = 70). Treatment adherence was assessed using the Morisky Medication Adherence Scale (MGL). Additional data on the patients’ basic information, annual income, education level, side effects, treatment efficacy, disease severity, and mental health (anxiety and depression) were also recorded. Univariate and multivariate analyses were used to identify factors associated with treatment adherence. The results showed that patients in the microneedling group demonstrated significantly higher treatment adherence compared to those in the medication group ( P  = 0.032). Within the microneedling group, adherence was significantly associated with age, education level, annual income, treatment duration, and side effects ( P  < 0.05). Specifically, patients over the age of 30, those with higher incomes, higher educational levels, and those with treatment durations of less than 3 months exhibited better adherence. Additionally, both treatment efficacy improvement and reduced anxiety were strongly correlated with better adherence ( P  < 0.001, P  = 0.010). In the medication group, side effects and treatment efficacy were significant factors influencing adherence ( P  = 0.001, P  < 0.001). Logistic regression analysis revealed that, within the microneedling group, patients with at least a middle school education or higher (OR = 0.031, P  = 0.035; OR = 0.016, P  = 0.041) and those who experienced improved treatment outcomes (OR = 0.002, P  = 0.006) were more likely to adhere to treatment. On the other hand, the occurrence of side effects significantly increased the likelihood of non-adherence (OR = 92.358, P  = 0.019). Patients with more severe conditions were more likely to adhere to treatment (OR = 0.035, P  = 0.038). In the medication group, those with stable or improved treatment outcomes showed better adherence (OR = 0.004, P  = 0.010; OR = 0.005, P  = 0.012). However, patients with more severe conditions were more likely to discontinue treatment (OR = 204.058, P  = 0.029), and depression was identified as a significant risk factor for non-adherence (OR = 586.074, P  = 0.004). Microneedling therapy demonstrates significant advantages in improving patient adherence, particularly by reducing side effects, enhancing perceived treatment efficacy, and improving mental health. Treatment efficacy and side effects are key determinants of treatment adherence, with patient age, education level, and income also playing an important role. Future studies should further explore the long-term efficacy and safety of microneedling therapy across different patient populations to optimize treatment protocols and improve adherence.

Androgenetic alopecia (AGA) is commonly treated with topical minoxidil, while platelet-rich plasma (PRP) and oral minoxidil offer alternative options. To compare the efficacy and safety of low-dose oral minoxidil (group 1) (G1), topical minoxidil (group 2) (G2), and PRP with topical minoxidil (group 3) (G3) in AGA. Seventy-five participants were randomly assigned to three treatment groups ( n  = 25),. Clinical and videodermoscopic assessments were performed at pre-scheduled intervals over 32 weeks, which was completed by 60 patients. At 32 weeks, 25% of patients in groups 1 and 3, and 10% in group 2 showed one grade improvement in AGA severity ( p  = 0.62). The median percentage increase in terminal hair density was 47.5 in G1, 48 in G2, and 57 in G3 at week 32 favoring G3 over G1 ( p  = 0.03) and G2 ( p  = 0.02). Median percentage decrease in vellus hair density was 26 in G1, 21 in G2, and 19 in G3, favoring G1 over G3 ( p  = 0.03), All 3 groups demonstrated a significant decrease in hair diameter diversity by 32 weeks, with no intergroup variation. The major side effects noted in G1 were headaches (20%), dizziness (15%), and pedal edema (5%). Scalp itching and dryness was observed in 75% of patients after topical minoxidil. Transient pain was observed in all patients during PRP procedure, along with minimal bleeding and dizziness in 15% and 5% respectively. Side effects experienced in all 3 groups were mild and were tolerated by most of the patients. The study emphasizes low-dose oral minoxidil as an effective alternative to topical minoxidil and also suggests the benefits of combining topical minoxidil with PRP.

Androgenetic alopecia in males is associated with genetic predisposition and increased androgen secretion. This work was to investigate the clinical therapeutic effects of microneedling plus5% Minoxidil and Finasteride in treating male androgenetic alopecia. 45 male patients with androgenetic alopecia were recruited and rolled into control group 1 (Group A) received monotherapy with 5% Minoxidil; control group 2 (Group B) received 5% Minoxidil and Finasteride; and the experimental group (Group C) received combination therapy with microneedling, 5% Minoxidil, and Finasteride. Each group consisted of 15 patients. Comparison was made on trace element levels, testosterone levels, hair microscopy indicators, Norwood Hamilton hair loss (HL) classification, self-rating of hair growth and Ars (ARs). After treatment, the contents of trace elements and hormone levels in the three groups did not change considerably( P  > 0.05). After treatment, the ratio of villi to single hair follicle in the three groups decreased markedly. The decline degree of group B and group C was superior to group A ( P  < 0.05), while that of group C was superior to group B ( P  > 0.05). After treatment, the hair density and hair shaft diameter of the three groups of patients increased markedly. The increase of group B and group C was superior to group A ( P  < 0.05), while that of group C was superior to group B ( P  > 0.05). After treatment, the Norwood-Hamilton alopecia scale in group C was better than that in group A ( P  < 0.01). A total of 80% patients in group C scored ≥ 3, which was better than the other two groups in general. The incidence of ARs differed slightly among the three groups ( P  > 0.05). Relative to the use of Minoxidil or combination therapy with Finasteride alone, microneedling combined therapy greatly improved hair loss in patients, promoted new hair growth, and holds clinical value.

Androgenic alopecia (AGA) is the most common form of non-scarring hair loss, characterized by marked hair follicle miniaturization. AGA is a challenging skin condition with limited treatment results. Laser light can promote hair growth at specific wavelengths. The efficacy of fractional CO2 laser in scalp AGA treatment was reported in a few studies. We aimed to compare the efficacy of fractional CO2 laser alone versus the combination of fractional CO2 laser with topical dutasteride in the treatment of male AGA. 30 male patients with AGA were enrolled in the study; they were divided into two groups. All patients received three sessions of ablative fractional CO2 laser one month apart on the scalp, where group (I) patients were subjected to laser sessions only, and group (II) patients were subjected to topical dutasteride, first immediately after each session and secondly fifteen days after each session. The evaluation was done according to dermoscopy (DermLite ® DL4) and photographic assessment. Patient satisfaction and side effects were reported. According to the global photo assessment, the combination of fractional CO2 laser with topical dutasteride showed a statistically significant improvement compared to the fractional CO2 laser alone group. The combination of fractional CO2 laser with topical dutasteride is more efficient in improving male androgenic alopecia than fractional CO2 laser alone according to the investigator’s global assessment. There was a significant improvement in all dermoscopic parameters in both groups.

Platelet rich plasma (PRP) was tested as a potential therapy for androgenetic alopecia (AGA) through two different clinical protocols in which one population (18 participants) received half-head treatment with autologous non-activated PRP (A-PRP) produced by CPunT Preparation System (Biomed Device, Modena, Italy) and the other half-head with placebo, and a second separated population in which all participants (n = 6, 3 participants per group) received treatment with calcium-activated PRP (AA-PRP) produced from one of two different PRP collection devices (Regen Blood Cell Therapy or Arthrex Angel System). For the A-PRP study, three treatments were administered over 30-day intervals. Trichoscan analysis of patients, three months post-treatment, showed a clinical improvement in the number of hairs in the target area (36 ± 3 hairs) and in total hair density (65± 5 hair cm2), whereas negligible improvements in hair count (1.1± 1.4 hairs) and density (1.9 ± 10.2 hair cm2) were seen in the region of the scalp that received placebo. Microscopic evaluation conducted two weeks after treatment showed also an increase in epidermal thickness, Ki67+ keratinocytes, and in the number of follicles. The AA-PRP treatment groups received a singular set of injections, and six months after the treatments were administered, notable differences in clinical outcomes were obtained from the two PRP collection devices (+90 ± 6 hair cm2 versus -73 ± 30 hair cm2 hair densities, Regen versus Arthrex). Growth factor concentrations in AA-PRP prepared from the two collection devices did not differ significantly upon calcium activation.

This study aimed to assess the impact of a combination of probiotic strains of Lactiplantibacillus on the treatment of androgenic alopecia (AGA). To this end, 136 individuals with AGA (62 men and 74 women) aged 18–65 years were enrolled in a double-blind, parallel-group clinical trial. A total of 115 individuals (57 in the probiotic group and 58 in the placebo group) completed this study within a 16-week intervention period. Capillary density, thickness, and length of hair were analyzed before and after the intervention using FotoFinder Trichoscale Pro. In addition, the gut microbiota was assessed by paired-end sequencing on the Illumina MiSeq platform (2 × 300 bp). At the conclusion of the treatment period, a notable decline (p < 0.05) in the number of telogen hairs was evident in the probiotic group while hair thickness decreased in the placebo group (p < 0.05). However, the remaining variables did not exhibit any statistically significant changes. In the probiotic-treated group, individuals aged less than 37.5 years exhibited a reduction in the number and density of telogen hair (p = 0.0693 and p = 0.0669, respectively) and an increase in hair length (p = 0.0871). Furthermore, a notable decline in the number and density of vellus hair (p < 0.05) was observed, and this was accompanied by no change in the hair thickness. The probiotic-treated group exhibited a significantly higher abundance of Lactobacillus (p-adjusted < 0.05, DEseq2 test) and demonstrated a notable reduction in the number and density of telogen hair, and this was accompanied by an increase in the percentage of anagen hair. The probiotic mixture was well tolerated by the participants, with a treatment adherence rate of 90%. In light of this study’s limitations, it can be concluded that a mixture of three strains of Lactiplantibacillus promotes the presence of terminal follicles, preventing their gradual miniaturization, which is a characteristic of AGA.

Background Androgenetic alopecia (AGA) affects both sexes equally and lasts long. AGA is the most common kind of hair loss in men. Gradual, pattern-based hair thinning on the scalp is a hallmark of the disease. The front, back, center, and sides of a man’s head are the most common areas where hair thinning and loss occur. Aim To evaluate the efficacy of microneedling-administered topical cetirizine in treating androgenetic alopecia in men. Methods A total of 80 AGA male patients were randomly assigned to this single-blind, parallel placebo-controlled study conducted at Beni-Suef University Hospital’s Dermatology Outpatient Clinic. Researchers allocated 40 patients to undergo topical cetirizine microneedling (MN) and 40 patients to saline MN for 8 weeks. Results In the 8th week, the cetirizine group demonstrated a greater prevalence of vellus hair (70.0%) than the saline group (30.0%), with a statistically significant difference ( p -value = 0.001). The majority of patients administered cetirizine by MN exhibited enhanced hair density (80.0%) in contrast to 25.0% in the saline group, with a statistically significant difference between the two groups ( p -value = 0.001). No notable adverse effects linked to the administration of cetirizine by MN were reported. Conclusion The microneedling of 1% topical cetirizine proved efficient in promoting hair growth without problems in the treatment of male androgenetic alopecia.

Canine Alopecia X is a non-inflammatory hair loss disorder of unknown etiology that predominantly affects German Spitz dogs. Treatment modalities include hormone and/or melatonin supplementation and low trauma microneedling. Melatonin influences hair growth and pigmentation in several species and presents a low risk of adverse effects when used in dogs with Alopecia X. Photobiomodulation (PBM) is frequently used in human androgenetic alopecia and alopecia areata; despite this, PBM remains unexplored in canine Alopecia X. To address this knowledge gap, sixty dogs of both sexes will be randomly assigned to three groups: (i) melatonin only group (3 mg/Kg, n = 20); (ii) PBM only group (diode laser, wavelength 660nm, 100mw power, with 3 J/point, 2 sessions/week for 3 months, n = 20); (ii) PBM + melatonin group (n = 20). The objective is to determine the potential of PBM alone or in conjunction with melatonin supplementation in promoting hair regrowth (hair density and diameter) by means of dermatoscopy and planimetry over a period of 90 days.