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Indian J Dermatol. 2010 Apr–Jun; 55(2): 148.

COMPARATIVE ASSESSMENT OF TOPICAL STEROIDS, TOPICAL TRETENOIN (0.05%) AND DITHRANOL PASTE IN ALOPECIA AREATA

Sudip Das, et al

There have been various controversial reports regarding the efficacy of topical agents in topical treatment of hair loss due to alopecia areata.

The study aims to find out the effective treatments.

Eighty patients were chosen from the skin OPD of Bankura Sammilani Medical College, Bankura, West Bengal, after evaluating the exclusion criterions. Treatments were continued for 3 month period and a follow up after further 3 months. After dividing them into four groups–group-I (topical steroids), group-II (topical tretinoin 0.05%) group-III (dithranol paste 0.25%), and group-IV (white soft petrolatum jelly)–patients were evaluated.Results:
Seventy percent of group-I, 55% of group-II, 35% of group-III, and 20% of the control group (white soft petrolatum jelly) responded favorably. Side effects in the form of dermatitis and hyperpigmentation were seen in group-III. However, no patient discontinued from the study.

We conclude that both topical steroids and tretinoin were fairly effective in limited variant of alopecia areata.

Keywords: Hair loss hair regrowth hai rloss treatment Alopecia areata, anthralin, topical steroids, tretenoin

edited for hair loss blog

Dermatol Online J. 2010 Feb 15;16(2):3.

Does D matter? The role of vitamin D in hair disorders and hair follicle cycling.
Amor KT, et al

Conclusion
Extensive data from animal models clearly show that the VDR, independent of vitamin D3 hormone, plays an important role in the hair follicle cycle, specifically anagen initiation. Studies have demonstrated the ability of vitamin D3 analogs to stimulate hair regrowth, but clinical trials of calcitriol in humans have been unable to replicate these results. Reasons for this may be that more potent analogs of vitamin D3 were used in the animal studies than the human trials. Also, the mechanism of hair recovery in nude mice may not be applicable to humans with alopecia. The latter is reflected in one study that used nude mice with congenital alopecia, which does not have an equivalent in humans. This review shows the need for further exploration of the role of vitamin D and the VDR in the hair cycle. For clinical hair disorders in which there is an abnormal hair cycle, such as chemotherapy-induced alopecia, treatments that up regulate the expression of the vitamin D receptor may be successful. Developments of such treatments are a future area of study. Furthermore, studies on the optimal levels of local and systemic vitamin D levels are still limited and there is currently no evidence-based data to recommend vitamin D supplementation for various types of hair loss. In order to fully understand the effects of vitamin D supplementation in alopecia, future studies should compare results in vitamin D deficient patients to those in vitamin D sufficient patients.

Hair Loss Treatment at the proctor clinic. We treat hair loss

Hair Loss Treatment, hair regrowth.

Br J Dermatol. 1999;141:398.Consequences of Pattern hair loss.

Cash TF.

edited and modified for hair loss blog use

…Hair loss is a common dermatological condition, with potentially adverse psychosocial sequelae. We examines evidence concerning the effects of hair loss on social processes and psychological functioning, as well as the psychosocial outcomes of hair loss treatments. There is a negative but modest effect of visible hair loss on social perceptions. More importantly, androgenetic alopecia is typically experienced as a moderately stressful condition that diminishes body image satisfaction. Deleterious effects on self-esteem and certain facets of psychological adjustment are more apparent among women than men and among treatment-seeking patients. Various ‘risk factors’ vis-à-vis the psychological adversity of pattern hair loss are identified. Medical treatments, i.e. minoxidil and finasteride, appear to have some psychological efficacy. A conceptual model is delineated to explain the psychological effects of hair loss and its treatment. Directions for needed research are discussed….

Curr Opin Pediatr. 2009;21:475

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An update on hair loss due to alopecia areata.
Kos L,

Hair loss due to alopecia areata is one of the most frequent organ-restricted autoimmune diseases, yet its pathogenesis is still unclear. In addition, although alopecia areata often results in significant psychological distress, effective treatment is lacking. New potential susceptibility loci have been implicated, but the strongest evidence points to certain class II human leukocyte antigen alleles. There is new evidence for the collapse of hair follicle immune privilege as a key step in the pathogenesis of alopecia areata. There is also new basic science evidence for stress as a contributing factor in the development of alopecia areata. Few treatments for alopecia areata have been well evaluated in randomized trials. Although multiple potential susceptibility loci have been implicated, the genetics of alopecia areata is still unclear. The role of any potential environmental contributors is also unclear. Quality evidence for efficacy in hair regrowth of currently used treatments for alopecia areata is lacking.

Br J Dermatol. 1978;99

The long term effect of repeated pluckings on the function of the mouse vibrissal follicles.
Ibrahim L, Wright EA.

Single mouse vibrissae were plucked repeatedly at the same time of the cycle (10–15 days after eruption) for ten successive cycles from eight individual follicles. After three pluckings the first grey whisker appeared, after six pluckings all regrown hairs were grey. Two follicles stopped hair regrowth after seven pluckings and another two after the 8th. Henceforth only 50% of the follicles continued producing whiskers until the end of the experiment. All the follicles which ceased to produce whiskers had a keratogenous cyst occupying most of the follicle in direct contact with the dermal papilla. In all cases the isolated dermal papilla was condensed and rounded in shape. Both loss of pigment and cyst formation could be due to the mechanical damage in the follicle caused by repeated plucking.

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Drugs. 2001;61:53.

Treatments for male pattern hair loss and alopecia areata: current options and future prospects.
Meidan VM, Touitou E.

Male pattern hair loss and alopecia areata are common disorders of the hair follicle which may heavily influence self esteem and self image. Androgenetic alopecia is caused by the heightened sensitivity of scalp follicles to dihydro- testosterone whereas alopecia areata is induced by an autoimmune reaction. Current drug treatment approaches include the use of hair regrowth stimulators such as topical minoxidil and oral finasteride for androgenetic alopecia, as well as topical minoxidil, dithranol (anthralin), corticosteroids, contact sensitisers, and psoralen plus ultraviolet A irradiation (PUVA) therapy for alopecia areata. Combination regimens are also proposed. However, extreme cases of either type of hair loss do not generally respond well to these existing treatments. For this reason, new therapeutic strategies are directed towards both improving the targeting of existing agents, as well as the development of novel hypertrichotic modalities.

…Our results demonstrate that caspases are expressed in discrete areas of the hair follicle and may control the hair loss andhair regrowth cycle. It appears that all the caspase family members are expressed in normal cells in an enzymatically inactive pro-form, and that upon the onset of apoptosis they are converted to an enzymatically active processed form via a poorly understood mechanism involving either oligomerization, self-proteolysis or cleavage by another family member or both. All members of the protease family show an extremely high prefe-rence for cleavage of their substrates after an aspartyl residue at the P1 position. Once activated, caspases are sensitive to inhibition by the viral products CrmA and p35, and perhaps more significantly from the point of normal regulation, by endogenous inhibitors, X-linked inhibitor of apoptosis (XIAP).