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Ludwig scale (1977). Grade I: Perceptible thinning of the hair on the crown, limited in the front by a line situated 1–3 cm behind the frontal hair line. Grade II: Pronounced rarefaction of the hair on the crown within the area seen in Grade I. Grade III: Full baldness (total denudation) within the area seen in Grades I and II.
Source publication
Fewer than 45% of women go through life with a full head of hair. Female pattern hair loss is the commonest cause of hair loss in women and prevalence increases with advancing age. Affected women may experience psychological distress and impaired social functioning. In most cases the diagnosis can be made clinically and the condition treated medica...
Citations
... The goal of treatment is to limit hair loss progression. The results of hair loss can be improved by hair styling, hair replacement and addition, hair transplants [131] or new techniques (growth factors from platelet-rich plasma [132,133] or stem cellbased therapies [134]). Optimal treatment of hirsutism involves hair removal (electrolysis, laser, and shaving) and lowering or exposure to androgens. ...
... As mentioned above, although oral contraceptives and progesterone have been used as primary therapeutic agents, their effects and populations are limited, and monitoring of blood glucose and lipids is required while taking them [131]. Studies have found that treating patients with pemphigus vulgaris with platelet-rich plasma can yield significant results, but more clinical evidence is needed [132]. ...
Polycystic ovary syndrome (PCOS) is an endocrine metabolic syndrome characterized by ovulation disorders, hyperandrogenemia, and polycystic ovaries, which seriously affect the psychological and physical health of childbearing women. N6-methyladenosine (m6A), as the most common mRNA epigenetic modification in eukaryotes, is vital for developing the female reproductive system and reproductive diseases. In recent years, an increasing number of studies have revealed the mechanisms by which m6A modifications and their related proteins are promoting the development of PCOS, including writers, erasers and readers. In this work, we reviewed the research progress of m6A in the pathophysiological development of PCOS from the starting point of PCOS clinical features, included the recent studies or those with significant findings related to m6A and PCOS, summarized the current commonly used therapeutic methods in PCOS and the possible targeted therapies against the m6A mechanism, and looked forward to future research directions of m6A in PCOS. With the gradual revelation of the m6A mechanism, m6A and its related proteins are expected to become a great field for PCOS treatment.
... Depending on whether it occurs before or after the menopause, it may be considered as either early-or late-onset [135]. The term FPHL is now more widely adopted than 'androgenic alopecia' in recognition of the fact that factors other than androgens may contribute to its pathophysiology [134,136]. Nevertheless, androgen excess remains an important cause of FPHL, and may cause distinct patterns of alopecia, including hair-loss with frontal accentuation [137] or central expansion of hair-loss with frontal hairline preservation [138]. ...
Context
Androgen excess is common in women and refers to clinical or biochemical evidence of elevated androgenic steroids such as testosterone. It is associated with underlying polycystic ovary syndrome in the majority of cases. However severe androgen excess is less common and may indicate the presence of underlying adrenal or ovarian neoplasms, genetic disorders or severe insulin resistance syndromes. Currently there are few consensus guidelines to assist clinicians with a standardised management approach to the patient with severe androgen excess.
Design
Clinical practice guideline.
Methods
This guideline has been developed with expertise from colleagues in endocrinology, gynaecology, clinical biochemistry and nursing, and furthermore provides a unique patient perspective to guide clinicians.
Results
The Society for Endocrinology commissioned this new guideline to collate multi‐disciplinary guidance for clinical practitioners in the investigation of severe androgen excess. Recommendations have been made in the areas of clinical assessment, biochemical work up, dynamic testing and imaging, informed where possible by the best available evidence.
Conclusion
This guideline will provide guidance for clinicians in their approach to patients with severe androgen excess.
... This reduction is associated with an increased occurrence of female pattern hair loss, highlighting estrogen's role in promoting hair growth. Additionally, the underlying causes and treatment approaches for conditions like hair loss and unwanted hair growth differ between postmenopausal and premenopausal women [17,18]. During pregnancy, high estrogen levels may help extend the hair's growth 7 phase, while a drop in estrogen after childbirth is believed to trigger a phase of increased hair shedding, commonly known as postpartum hair loss [19,20]. ...
Introduction and purpose: Hair loss, clinically referred to as alopecia, represents a significant dermatological challenge that impacts millions of people worldwide. This disorder can lead to significant psychosocial distress, affecting self-esteem and quality of life across different age groups and genders. Its multifactorial etiology involves genetic predispositions, hormonal imbalances, immune-mediated mechanisms, and environmental influences. This literature review focuses on the latest reports on the pathogenesis of hair loss and summarizes current strategies for its prevention. State of knowledge: Hair loss occurs when the normal hair growth cycle is disrupted, leading to premature shedding. Genetic predisposition, especially in androgenetic alopecia, increases follicle sensitivity to hormonal changes. Androgens shorten the growth phase and thin hair, while estrogen decline in women can worsen hair loss. Other hormones such as growth hormone, prolactin, melatonin, cortisol, and thyroid hormones also play key roles in hair maintenance. Stress elevates cortisol, which can push hair into its resting phase earlier than normal. Immune responses in conditions like alopecia areata result in the body attacking its own hair follicles. Environmental pollutants and nutritional deficiencies further compromise hair structure. Preventive measures- such as balanced nutrition, stress management, and topical treatments- can help maintain healthier hair. Conclusion: By deepening our understanding of the pathogenesis of hair loss, we can enhance our ability to diagnose the condition and identify its underlying causes. Given the diverse etiologies, each patient should be evaluated individually, with treatment tailored to the specific findings of their examination.
... At this point, Türkiye, which is one of the prominent countries among the destinations where hair transplantation operations are performed, draws attention with its success in this field (Tamer Bakar & Akyurek, 2021). However, hair transplantation is not only a technical intervention, but also includes many different dimensions that should be considered as part of health care (Dinh & Sinclair, 2007). ...
This research aims to evaluate the experiences of international tourists who travel to Türkiye for hair transplant procedures and the quality of services they encounter throughout this process. By analysing tourists’ perceptions through reviews on Trustpilot, the research identifies key service components that shape these experiences, shedding light on the multidimensional nature of hair transplant tourism. The research employs a content analysis approach to analyse online reviews collected from Trustpilot. This qualitative method allows for an in-depth understanding of tourists’ experiences with various aspects of hair transplant services in Türkiye, focusing on six main components. This research contributes to the medical tourism literature by providing a comprehensive model that encapsulates the full patient journey in hair transplant tourism. By highlighting the importance of interconnected service components, it offers practical insights for clinics and sector stakeholders to enhance patient experience. The research identifies that hair transplant procedures represent a multifaceted experience where each service component plays a crucial role in the overall journey. It was determined that the experiences of tourists travelling for hair transplantation consist of six main components, including ‘clinic and equipment quality’, ‘service quality’, ‘price-performance perception’, ‘transfer and accommodation services’, ‘fulfillment of expectations’, ‘follow-up processes’.
... Bu genetik ve hormonal etkileşim, saç büyümesinin bireysel ve bölgesel değişkenliklerini belirleyen önemli bir faktördür (Heilmann-Heimbach & ark., 2020). Benzer şekilde, kadın tipi saç dökülmesi kadınlarda en sık görülen saç dökülmesi şeklidir (Dinh & Sinclair, 2007) ve yaygınlık değerleri erkek tipi saç dökülmesi ile karşılaştırılabilir düzeydedir. Erkek tipi saç dökülmesi, genellikle saç kaybının şiddeti ve yaygınlığını değerlendiren Norwood-Hamilton Sınıflandırması ile tanımlanır. ...
... Frontal saç çizgisi çoğunlukla korunur, ancak saç yoğunluğunda genel bir azalma gözlenir. Bu sınıflandırma sistemleri, erkek ve kadınlarda saç dökülmesi paternlerinin klinik olarak farklı olduğunu ortaya koyarak teşhis ve tedavi planlamasında önemli bir rehber oluşturur (Dinh & Sinclair, 2007;Stough & ark., 2005;Venkataram, 2006;Scheinfeld, 2008). ...
... Bununla birlikte, Dutasterid, bazı ülkelerde saç dökülmesi tedavisi için resmi olarak onaylanmamıştır ve genellikle etiket dışı olarak kullanılmaktadır. Bu tedavinin uzun dönemli güvenliği ve etkinliği üzerine yapılan araştırmalar halen devam etmektedir (Dinh & Sinclair, 2007). Latanoprost, genellikle glokom tedavisinde kullanılan bir prostaglandin analoğudur. ...
... Spironolactone is a weak competitive anti-androgen that also decreases the synthesis of testosterone and is used widely to treat FPHL and hirsutism. Low-dose spironolactone 50-100 mg daily is generally well tolerated, but at higher doses (150-200 mg daily) its additional physiological effects as an aldosterone antagonist can lead to postural hypotension, electrolyte disturbances, and fatigue [85]. There are case reports of the efficacy of non-steroidal antiandrogens such flutamide in women with hair loss who do not respond to spironolactone [86]. ...
... For trans women with moderate to severe hair loss, an integration, hairpiece, or wig may be better options. Fashion accessories including hats, scarves, and bandanas can satisfactorily conceal localized or diffuse patches of hair loss [85]. ...
Chest pain is a symptom that is potentially life-threatening and requires quick and accurate evaluations. This article describes the quality of guidelines related to the evaluation and diagnosis of acute, undifferentiated chest pain. After systematically evaluating existing guidelines, we found that there exists a wide variety of quality in these documents. Future documents that provide recommendations should utilize guideline evaluation tools during the creation process to ensure a high-quality product, regardless of document type.
... The exact underlying pathogenetic mechanism remains unknown at large. Though hairfall has been prevailing in the society since long, however, not many definitive treatment options are available till 2 date. Hairfall following COVID-19 infection poses a unique challenge due to the acute insult of systemic inflammation and its impact on multiple organ systems alongwith the variety of medications used in 3 the management. ...
Background: Hair fall is a major concern amongst the COVID-19 survivors. It causes much psychological distress. The exact underlying pathogenetic mechanisms are unknown. Thus, the present study was conducted to assess the factors associated with hairfall amongst COVID-19 survivors Method:Atotal of 464 cases having recovered from COVID-19 infection atleastthree months back were included in the study, provided they met the inclusion and exclusion criteria. Questionnaires were administered through google forms. Demographic details, details about COVID-19 infection and hairfall were collected and data was analysed. Results: The hairfallfollowing COVID-19 infection was significantly more in the females; P value: less than 0.001. There was no difference in hairfall according to the presence of comorbidities (thyroid disorder, anemia, DM). The hairfall was significantly more in the cases requiring hospital admission and in those requiring oxygen supplementation at home; P value: less than 0.05. Conclusion: It can be effectively concluded that hairfallfollowing COVID-19 infection affects females more than males. It is also significantly related to the severity of the COVID-19 infection.
... Studies have shown that deciencies in essential micronutrients can disrupt energy metabolism and affect (7) physiological functions critical for maintaining healthy hair growth . The global prevalence of nutritional deciencies, especially in lowsociodemographic-index countries, highlights the need for effective (8,9) diagnostic and interventional strategies . ...
Aim & Objective: To evaluate the efcacy of trichoscopy in identifying deciencies of Vitamin B12, Vitamin D3, and serum ferritin in patients with Telogen Efuvium (TE). Background/Introduction: Telogen efuvium (TE) is a common cause of diffuse hair loss often triggered by various factors, including nutritional deciencies. Material & Methods: This cross-sectional descriptive study was conducted from May 2023 to August 2023. Fifty participants aged 19-45 years with clinically diagnosed TE and conrmed deciencies in Vitamin B12, Vitamin D3, and/or serum ferritin were included. Trichoscopic evaluations were performed using a Dermlite DL4 dermatoscope. Results: The majority of participants (88%) were female, with signicant correlations found between serum Vitamin D3 and Vitamin B12 levels (r = .316, p = .025) and between serum Vitamin D3 and ferritin levels (r = .299, p = .035). Specic trichoscopic patterns were signicantly associated with these deciencies, particularly the presence of few vellus hairs (p = 0.019). Conclusion: Identifying specic trichoscopic patterns linked to B12, D3, & ferritin deciencies can aid in early diagnosis and management, reducing the need for invasive blood tests.
... Cosmetic methods for managing hirsutism include plucking, shaving, waxing, chemical treatment and electrolysis [54]. Acne can be managed with laser or light therapy [55] or cosmetic surgery for severe scarring, and the effect of alopecia might be ameliorated with hairstyling, hair replacement and additions, hair transplantation [56]. Effective topical drugs might include retinoids [57] for acne and minoxidil for alopecia [58]. ...
Background
Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder in premenopausal women, often linked to abdominal obesity, insulin resistance, and metabolic issues. With its heterogeneous nature, PCOS treatment should be tailored to individual symptoms and patient preferences. This study examines collaboration networks among countries, institutions, authors, references, and journals related to PCOS treatment.
Methods
Web of Science data was analyzed using VOSviewer and CiteSpace for bibliometric visualization. Chinese and Western medicine treatments for PCOS were reviewed, emphasizing symptom-targeted solutions.
Results
Data from 4682 records authored by 400 individuals from 515 institutes in 62 countries revealed China as the leading contributor. Notable authors include Monash University and Richard S. Legro. Common research themes include adipocytes, inflammation, insulin sensitivity, oxidative stress, and the gut microbiome. Tailoring treatment to individual needs is essential, focusing on hyperandrogenism, ovulation, and insulin resistance, with lifestyle counseling to address obesity.
Conclusion
This bibliometric analysis provides valuable insights into the research status of PCOS treatment. China has made significant contributions, and complementary and alternative therapies, such as traditional Chinese medicine and acupuncture, have also shown beneficial effects recently. The research on inflammation, oxidative stress, and the gut microbiome may provide new targets and strategies for the treatment of PCOS. The recognition of the metabolic problems in PCOS patients facilitates the formulation of more personalized treatment plans to improve the prognosis of patients.
... These findings agree with the results found by. (12) (22) The hair loss may occur at all ages. Therefore, loss of hair becomes a problem of concern in all individuals irrespective of age and sex. ...
... Therefore, loss of hair becomes a problem of concern in all individuals irrespective of age and sex. (12) (22) This study showed a significant difference in mean zinc between patient and control group (p=0.021). Control group have higher zinc level (93.82 mg/dl) compared to patient group (82.59 mg/dl) and these result agree with that of. ...
Hair loss is a difficult problem that is common to many 'dermatologists'. It is also considered an annoying trouble for females due to the relationship between hair within femininity, beauty and individual strength, and therefore it may cause psychicl trouble for them. especially in the city of Ramadi (Western Iraq), (, there was little attention to it. The study aimed to Validating role of the main physiological of the common causes of hair loss. The study was conducted during the period from March to September, 2022. This study was applied on 80 volunteer women who visited the dermatology clinics in general Ramadi hospital. The blood sample was collected from the patient group (A total of 52 volunteer women with suffering hair loss), along with the control group (28 healthy women) for the purpose of comparison. Serum T3, T4, TSH, Vit D3 and Ferritin level measured by using the Cobase 411(Roche) full-automated mechanics. The result showed 'a significantly lower' level in the concentration of vitamin D3, vitamin B12 and serum ferritin and a significant higher mean in serum concentration of T3 hormone in the group of patients. Additionally, the results exhibited non a significantly different in age, Hb, T4 and TSH of patient group compared to the control group. This study demonstrated the importance of physiological factors might play a major role in the etiology of hair loss between women in the city of Ramadi.
