Hair restoration in the ethnic patient and review of hair transplant fundamentals.
Lam SM, Karamanovski E.

Willow Bend Wellness Center, Lam Facial Plastic Surgery Center and Hair Restoration Institute, Plano, TX 75093, USA

Abstract
Superior hair restoration requires the application of universal principles along with variations that apply to specific ethnic populations. This article serves as a primer on basic tenets of hair restoration, with additional attention given to the uniqueness and differences in technique and design that are warranted for a wide range of races and ethnicities. This article also gives prospective surgeons an insight on how to undertake further study and shore up their deficiencies so as to refine knowledge gaps and ensure patient safety and excellent surgical outcomes. Copyright 2010 Elsevier Inc. All rights reserved.

Modified for hair loss treatment blog

Innovative use of spironolactone as an antiandrogen in the treatment of female
pattern hair loss.

Rathnayake D, Sinclair R.

edited for hair loss blog

Pattern hair loss in men and women, although medically benign, is a common,
albeit unwelcome, event that may cause considerable anxiety and concern.
Patterned hair loss is progressive and when untreated leads to baldness. The
prevalence and severity of this physiologic process both increase with advancing
age. Although androgens play a key role in the pathogenesis of male pattern hair
loss (MPHL), the role of androgens in female pattern hair loss (FPHL) is less
well established. Satisfactory treatment response to antiandrogen therapy
supports the involvement of androgens in the pathogenesis of FPHL. Spironolactone
has been used for 30 years as a potassium-sparing diuretic. Spironolactone is a
synthetic steroid structurally related to aldosterone. Since the serendipitous
discovery 20 years ago that spironolactone given to a woman for polycystic ovary
syndrome (PCOS) and associated hypertension also improved hirsutism, it has been
used as a primary medical treatment for hirsutism. Spironolactone both reduces
adrenal androgen production and exerts competitive blockade on androgen receptors
in target tissues. Spironolactone has been used off-label in FPHL for over 20
years. It has been shown to arrest hair loss progression with a long-term safety
profile. A significant percentage of women also achieve partial hair regrowth.
Spironolactone is not used in male androgenetic alopecia because of the risk of
feminization.

hair loss treatment and regrowth

Castro-Magana M, et al

We studied the testicular function and some androgen-mediated events in 22 males with male pattern hair loss treated with finasteride for 2 years. snip… Serum gonadotropin, prostate-specific antigen (PSA), and sex hormone levels were determined basally and periodically during the treatment period. Fourteen subjects underwent gonadal stimulation with human chorionic gonadotropin, and the gonadotropin response to gonadotropin releasing hormone was determined in eight subjects, prior to and after 2 years of therapy. Finasteride treatment resulted in an improvement in the male pattern hair loss and prostatic shrinkage that was associated with an increase in serum testosterone levels and a decrease in dihydrotestosterone levels, causing a marked increase in that testosterone/DHT ratio. A significant increase in the serum levels of androstenedione and estradiol snip.. No changes in basal or stimulated levels of gonadotropin were observed. There was a significant increase in the testosterone response to hCG during finasteride therapy that could be explained, at least in part, by the reduction of testosterone metabolism resulting from the blockage induced by finasteride. The decrease in the androstenedione to testosterone and estrone to estradiol ratios observed after hCG treatment, however, strongly suggests increased activity of the 17-ketosteroid reductase enzyme and an improvement of the testicular capacity for testosterone production.
hair loss and hair loss regrowth

edited for hair loss blog

The longest telomeres: a general signature of adult stem cell compartments.
Flores I, et al

….these findings demonstrate a hierarchical organization of cells of a common origin within tissues according to their telomere length in all organs examined so far (hair follicles, small intestine, cornea, testis, and brain), with the longest telomeres generally marking the most primitive adult stem cell compartments and the shortest telomeres in the more differentiated compartments within a given tissue. Of note, the rate of telomere shortening within a given tissue appeared larger than expected from mere cell division, which may reflect on active telomere degradation mechanisms associated with differentiation, something that remains unexplored to date. Since cell hierarchies are general features of almost all adult organs, identification of the longest telomeres may represent a novel general marker of adult stem cell compartments, which combined with current ways to identify stem cells such as the so-called “label-retaining techniques” may be useful in identifying new stem cell compartments.Finally, we make the novel finding that Mus musculus telomeres shorten with age in all different stem cell compartments studied here, which in turn may result in decreased stem cell functionality at old age. The correct identification and characterization of adult stem cells in healthy and disease conditions could lead to new clinical applications, such as aid in their isolation as well in the study of their response to different treatments, such as in hair loss…..

Edited.

edited for use in this hair loss treatment blog

The Dundee experimental bald rat undergoes hair loss associated with perifollicular infiltrates of mononuclear cells (MNC), a pathological characteristic of human alopecia areata (AA). ..snip… There was a good correlation between the degree of leucocyte (OX-1+) infiltration of anagen hair follicles and the development of hair loss. ..snip… Active and established lesional rats, i.e. animals with overt loss of hair, showed a significant increase in the degree of MNC infiltration and the proportion of infiltrated follicles, the majority of which were in dystrophic anagen. ..snip.. These results show marked similarities to lesional human AA. They also focus on a possible active role for CD8+ cells in the pathogenesis of hair loss in the DEBR rat.

Massive lymphocyte-mediated apoptosis during the early stage of pseudopelade.

Pierard-Franchimont C, Pierard GE
.
The early evolving lesions of the hair follicles are described in pseudopelade, a type of cicatricial hair loss where clues for the diagnosis of lupus erythematosus or lichen plano-pilaris are lacking. A sudden and synchronized cell death of all the cells of the epithelial sheaths of the hair follicles occurs and is associated with a dense infiltration by lymphocytes. The epidermis remains uninvolved. This unique aspect is most probably related to the mechanism of apoptosis. Its intensity and extension are much more pronounced than in lichen planus and in lupus erythematosus. Pathogenesis of at least some cicatricial causes of hair loss could therefore be related to massive apoptosis without evident and close relationship with the classical etiologies, i.e. lichen planus and lupus erythematosus.