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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.

Background. Androgenetic alopecia (AGA) represents the most frequent clinical complaint encountered by dermatologists and is characterized by a progressive miniaturization of the hair follicle. However, the efficacy and safety of current medical treatment remain limited, and more personalized therapeutic approaches for AGA are needed. Therefore, the present study is aimed at investigating the efficacy and safety of botulinum toxin type A (BTA) in patients with AGA. Methods. 63 patients with AGA meeting the inclusion criteria were included in this study and treated with BTA injection or BTA injection combined with oral finasteride (FNS). In the scalp, 30 sites were injected with 100 U of BTA in each site and patients received BTA after every 3 months for a total of 4 times. Hair counts, head photographs, evaluation scores, and self-assessment were assessed in patients with AGA. Results. Hair counts in both groups at all time points were significantly higher as compared with those before treatment. After 4 times of treatment, hair counts in the BTA+FNS group were higher than those in the BTA group. Hair growth and density were significantly augmented, and the area of hair loss was attenuated after each treatment as revealed by head photographs. The effective rates of BTA and BTA+FNS groups were 73.3% and 84.8%, respectively, following 4 times treatment. Conclusion. BTA is a safe and effective therapeutic strategy for the treatment of AGA without adverse effects, and BTA combined with FNS exhibited a superior therapeutic effect than BTA alone.

Alopecia Areata (AA) is a chronic, immune-mediated inflammatory condition primarily targeting hair follicles, leading to non-scarring hair loss. Traditional therapeutic approaches, including topical and systemic immunosuppressive treatments, often yield inconsistent results and carry significant side effects. Recently, laser therapy has emerged as a promising modality for AA treatment, particularly when combined with adjunctive agents that enhance hair follicle stimulation. This study evaluates the efficacy and safety of a novel therapeutic combination: CO2 fractional laser therapy with Bimatoprost 0.03% solution application. Conducted at Al-Azhar University Hospital between January 2019 and May 2023, the study involved 60 patients with clinically and dermoscopically confirmed AA. Participants were randomly assigned into two groups: Group A ( n  = 30) received three CO2 fractional laser sessions with subsequent daily application of Bimatoprost 0.03%, while Group B ( n  = 30) underwent laser therapy alone. Clinical outcomes were assessed using standardized photographic documentation, dermoscopic evaluation, and patient-reported improvement scores. Results demonstrated a significantly higher response rate in Group A compared to Group B (80% vs. 40%, p  = 0.025). The combination therapy led to faster and more pronounced hair regrowth, with notable improvements in hair density, pigmentation, and thickness. Minimal adverse effects were reported, limited to transient erythema and mild procedural discomfort. Statistical analysis confirmed a superior treatment response in Group A across all assessment parameters ( p  < 0.05). These findings suggest that the combination of CO2 fractional laser therapy with Bimatoprost 0.03% offers a safe and effective treatment modality for AA, outperforming laser therapy alone. This study provides a foundation for further research and highlights the potential integration of prostaglandin analogs with laser-based interventions in AA management. Future studies with larger sample sizes and extended follow-up periods are necessary to validate these promising results and assess long-term treatment sustainability.

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.

Hair follicle development and hair growth are regulated by multiple factors and multiple signalling pathways. The hair follicle, as an important skin appendage, is the basis for hair growth, and it has the functions of safeguarding the body, perceiving the environment and regulating body temperature. Hair growth undergoes a regular hair cycle, including anagen, catagen and telogen. A small amount of physiological shedding of hair occurs under normal conditions, always in a dynamic equilibrium. Hair loss occurs when the skin or hair follicles are stimulated by oxidative stress, inflammation or hormonal disorders that disrupt the homeostasis of the hair follicles. Numerous researches have indicated that oxidative stress is an important factor causing hair loss. Here, we summarize the signalling pathways and intervention mechanisms by which oxidative stress affects hair follicle development and hair growth, discuss existing treatments for hair loss via the antioxidant pathway and provide our own insights. In addition, we collate antioxidant natural products promoting hair growth in recent years and discuss the limitations and perspectives of current hair loss prevention and treatment.

Fractional 1550-nm erbium-glass (Er:Glass) laser therapy is effective in inducing hair regrowth. Combining fractional Er:Glass laser therapy with topical minoxidil may yield therapeutic benefits for patients with androgenetic alopecia (AGA). To compare the efficacy and safety of fractional Er:Glass laser used in combination with topical 5% minoxidil versus 5% minoxidil alone for the treatment of male AGA, 30 men with AGA were randomized to 24 weeks of split-scalp treatment using fractional Er:Glass laser and 5% minoxidil on one side (combined therapy) or 5% minoxidil alone on the other side (monotherapy). The primary outcome was the difference in hair density and diameter, from baseline, between two treatment sides, at week 24. The secondary outcome was a global photographic assessment, evaluated by two dermatologists and the participants. Adverse events were evaluated. Twenty-nine participants completed the 24-week study period. Combination therapy provided significantly superior results for both the primary and secondary outcomes (all p < 0.05). No serious adverse events were identified for either treatment. In conclusion, combination therapy, consisting of fractional Er:Glass laser and topical minoxidil, is a promising treatment option for AGA. Laser-induced photothermolysis and the formation of effective routes for transdermal drug delivery are possible mechanisms. clinicaltrials.in.th, identifier TCTR20160912001

Current FDA-approved treatments for androgenetic alopecia (AGA) are oral finasteride and topical minoxidil. Topical finasteride offers a potential alternative with similar efficacy and fewer systemic side effects. This study evaluated the effectiveness and safety of combining topical finasteride and minoxidil for male AGA. This 12-week randomized controlled trial divided subjects into two groups which are topical finasteride 0.1%-minoxidil 5% (treatment) and topical minoxidil 5% (control) (NCT05990400, registered 2023-08-04). Hair density, hair diameter, terminal hair rate, and vellus hair rate (assessed using phototrichogram), and the occurrence of side effects (SE) was monitored at four-week intervals. Out of 40 subjects, 2 dropped out in the treatment group. Significant increases in hair density, diameter, and terminal hair rate; and decrease of vellus hair rate were observed at each visit compared to baseline, yet no differences between groups. Systemic SEs included libido reduction (control), mild erectile dysfunction, and chest pain (treatment). Common local SEs (itching, shedding, and dandruff) were similar between groups. One patient (treatment) experienced contact dermatitis. Combining topical finasteride 0.1% with topical minoxidil 5% has similar safety and effectiveness for increasing hair density and diameter in male AGA patients compared to topical minoxidil 5% after 12 weeks of observation.

Background The relationship between female pattern hair loss (FPHL) and androgenic hormones is not well established, but some evidence indicates oral finasteride may be efficacious in FPHL. Use of a topical formulation has been proposed to minimize unwanted effects. Objectives Our objective was to compare the efficacy and safety of topical 0.25% finasteride combined with 3% minoxidil solution and 3% minoxidil solution as monotherapy in the treatment of FPHL. Methods This was a prospective, randomized, double-blind study in 30 postmenopausal women with FPHL. Each participant was randomized to receive either topical 0.25% finasteride combined with topical 3% minoxidil or topical 3% minoxidil solution as monotherapy for 24 weeks. To determine efficacy, the hair density and diameter was measured and global photographic assessment was conducted at baseline and 8, 16, and 24 weeks. Side effects and serum dihydrotestosterone levels were also evaluated. Results By 24 weeks, hair density and diameter had increased in both groups, and finasteride/minoxidil was significantly superior to minoxidil solution in terms of hair diameter ( p  = 0.039). No systemic side effects were reported. However, serum dihydrotestosterone levels in the finasteride/minoxidil group significantly decreased from baseline ( p  = 0.016). Conclusion A topical combination of 0.25% finasteride and 3% minoxidil may be a promising option in the treatment of FPHL with an additional benefit of increasing hair diameter. Nevertheless, as it may be absorbed percutaneously, it should be reserved for postmenopausal women. Trial Registration clinicaltrials.in.th; identifier TCTR20160912002.

Androgenetic alopecia is one of the most common cause of hair loss disorder. This hereditary and androgen-dependent disorder tends to progress into partial or even complete baldness Several therapeutic options are now available for AGA, including conventional medications such as finasteride, dutasteride, and minoxidil. However, side effects of these medications are also commonly reported. The use of adipose derived stem cells and their secreted bioactive molecules, “secretome” has gained attention which could produce many effects for hair growth promotion and has been proven in clinical trials. This study aims to compare the effectiveness and safety of with minoxidil in androgenetic alopecia cases. 60 subjects were divided into three treatment groups (minoxidil only, secretome only, and combination of both) and were given intervention on week 0, 4, and 8. All subjects were evaluated by physical examination, photography, trichoscopy, and trichoscan until week 12. All groups showed a statistically significant improvement ( p  < 0.05) on hair growth parameters with the best improvement observed on week 12. The combination group had the best improvement substantially on hair growth parameters. Side effects are minimum and reported by the subjects in minoxidil group. Clinicaltrials.gov, NCT06066827. Registered 05 October 2023, Retrospectively. https://register.clinicaltrials.gov/prs/app/template/Home.vm?uid=U0004ES6_ts=7_sid=S000DOK9_cx=-igh2d .

This narrative review aims to examine the therapeutic potential and mechanism of action of plant extracts in preventing and treating alopecia (baldness). We searched and selected research papers on plant extracts related to hair loss, hair growth, or hair regrowth, and comprehensively compared the therapeutic efficacies, phytochemical components, and modulatory targets of plant extracts. These studies showed that various plant extracts increased the survival and proliferation of dermal papilla cells in vitro, enhanced cell proliferation and hair growth in hair follicles ex vivo, and promoted hair growth or regrowth in animal models in vivo. The hair growth-promoting efficacy of several plant extracts was verified in clinical trials. Some phenolic compounds, terpenes and terpenoids, sulfur-containing compounds, and fatty acids were identified as active compounds contained in plant extracts. The pharmacological effects of plant extracts and their active compounds were associated with the promotion of cell survival, cell proliferation, or cell cycle progression, and the upregulation of several growth factors, such as IGF-1, VEGF, HGF, and KGF (FGF-7), leading to the induction and extension of the anagen phase in the hair cycle. Those effects were also associated with the alleviation of oxidative stress, inflammatory response, cellular senescence, or apoptosis, and the downregulation of male hormones and their receptors, preventing the entry into the telogen phase in the hair cycle. Several active plant extracts and phytochemicals stimulated the signaling pathways mediated by protein kinase B (PKB, also called AKT), extracellular signal-regulated kinases (ERK), Wingless and Int-1 (WNT), or sonic hedgehog (SHH), while suppressing other cell signaling pathways mediated by transforming growth factor (TGF)-β or bone morphogenetic protein (BMP). Thus, well-selected plant extracts and their active compounds can have beneficial effects on hair health. It is proposed that the discovery of phytochemicals targeting the aforementioned cellular events and cell signaling pathways will facilitate the development of new targeted therapies for alopecia.