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The effect of hair loss on quality of life
Abstract
The aim of this study was to quantify the effect of hair loss on quality of life. Patients were recruited from an alopecia support group, and were assessed using the Dermatology Life Quality Index (DLQI) and an adapted version of the DLQI. Financial utility questions, an abbreviated version of the Center for Epidemiologic Studies Depression Scale and open-ended questions were also used.
Seventy (90% response rate) questionnaires were returned. DLQI scores in responders with hair loss (mean score = 8.3, SD = 5.6, range 0-23, n = 70) were similar to those recorded in severe psoriasis. The hair loss continued to have a significant impact on life quality well after the initial event (median duration of hair loss = 138 months +/- 114; range 7-588, n = 70). Forty per cent of patients also felt dissatisfied with the way in which their doctor dealt with them.
This study specifically identifies the feelings of loss of self-confidence, low self-esteem and heightened self-consciousness in people affected by hair loss.
... Hair fall is a common and stressful symptom, distressing the quality of life of an individual, thereby necessitates optimal therapy [15]. For the treatment of alopecia, allopathic medications, including minoxidil and finasteride, are available on the market, but many of them fall short of expectations and have undesirable adverse effects, including hypotension, recurrence of alopecia, loss of libido, impotence, decreased ejaculate volume, swelling of the lips, skin rashes, and others [6,[17][18][19]. ...
... Alopecia is a disorder that affects both men and women [1,2]. Although it is not incapacitating, it can cause considerable psychological and social discomfort [1,2,15]. Currently, alopecia treatment standards include surgical procedures and pharmacological treatments that include topical and oral pharmaceutical drugs [16,17]. ...
... Studies have associated alopecia negatively impacting the personality and quality of life (QoL) of an individual [15,37]. In this study, we observed that participants receiving Ashwagandha topical formulation (serum) had a substantial improvement in quality of life, as seen by a lower score in Hair specific Skindex-29 scale as compared to the Placebo group (p < 0.05). ...
Background
Alopecia is a dermatological condition affecting genders, negatively impacting their personality and quality of life (QoL). The current approved entities are limited, inconsistently effective, and associated with negative side effects. To alleviate this issue, ayurvedic herbs such as Ashwagandha have being explored. As a result, this study was designed to evaluate the efficacy and safety of Ashwagandha (root extract) topical formulation (serum) on hair health in healthy adults.
Methods
In this prospective, double-blind, randomized, placebo controlled, two arm, parallel, comparative study, the effects of topical Ashwagandha on the hair health was evaluated. Healthy adults between 18 and 45 years with mild to moderate hair loss were randomized to either Ashwagandha (topical) or Placebo (topical) treatment. The participants were assessed at Day-1 and Day-75 for change in efficacy parameters, which included 60 Seconds Hair Comb, Trichoscan analysis, Hair Pull test, Investigator's Global Assessment (IGA) and QoL using Hair-specific Skindex-29.
Results
In the per protocol analysis of 61 participants, Ashwagandha group demonstrated significant reduction in hair shedding in the 60 Seconds Hair Comb test compared to Placebo at day 75. Similarly, Ashwagandha substantially enhanced hair density, growth, and thickness compared to the Placebo group (density = 7.3 vs. 2.8, P < 0.001; growth = 21.7 vs. 4.2, P < 0.001; thickness = 1.8 vs. 0.9, P < 0.001). In addition, Ashwagandha significantly improved QOL compared to placebo (Score = −17.3 vs. −6.1, P = 0.011).
Conclusion
The study found that topical Ashwagandha (serum) improved hair growth and hair health indicators. Thus, it can be an effective and safer alternative for alopecia.
Study registration
CTRI, Number CTRI/2022/11/047539, Registered on: 23/11/2022.
... The impact on the quality of life of those who suffer from hair disorders is comparable to those who have skin diseases such as psoriasis in plaques. 1 On the other hand, individuals without any capillary disorder look for treatments to increase hair growth and thickness, in addition to strengthening the shaft from products marketed for this purpose but without any scientific proof. ...
... Exfoliative erythroderma (EE), exfoliative dermatitis, or simply erythroderma, first described by Von Hebra in 1868, is a rare disorder in which erythema and desquamation occur, involving more than 90% of the body surface. 1 Previous studies have shown the main etiology to be pre-existing (or underlying) dermatoses, followed by medications and, less commonly, neoplasms. 2---4 We assume that increased use and access to new drugs, and drug interactions, especially in the elderly, may be modifying the epidemiology, with drugs being the main etiology of EE. ...
... The incidence of AGA increases with age and affects up to 50% of all men by age 50 and 80% by age 80 [4]. Hair loss can reduce body image satisfaction, leading to fear of social rejection and a perception of losing social attractiveness [5] Aukerman et al., screened a total of 13 studies (dated from 1992 to Juniper Online Journal of Dermatology & Cosmetics 2021) and found that AGA patients express feelings of anxiousness, helplessness, low self-esteem, and fear of increased hair loss. This psychosocial stress leads to a decline in the quality of life [6]. ...
ntroduction: Hair loss can reduce body image satisfaction, leading to fear of social rejection and a perception of losing social attractiveness. Androgenetic alopecia (AGA) is a hair loss condition that primarily affects the top and front of the scalp. Current treatment options for AGA include the U.S. Food and Drug Administration approved topical Minoxidil and oral Finasteride. In addition, many therapies have been suggested for the treatment of AGA, however the outcomes of those treatments vary widely, with limited or no satisfaction being reported. The Triple Hair Inc. company designed the TH07 formula, which contains 3 drugs that have already demonstrated their ability to induce hair re-growth, while still being safe in animal models and human clinical trials. The goal of the current trial was to evaluate the satisfaction of AGA patients with the TH07 treatment.
... This impact is evidenced by the higher prevalence of depressive symptoms and anxiety in patients with alopecia, especially among women. 3,4 Few studies have investigated the impact of QoL induced by FFA, but most patients recognize that their QoL is affected by it. 5 Porriño-Bustamante et al. developed and validated a specific instrument to investigate the impact on QoL in women with FFA, the Frontal Fibrosing Alopecia Quality of Life Index (FFA-QLI). ...
... Williamson et al. illustrated the detrimental effect of hair loss on the quality of life such as loss of self-confidence, low self-esteem, and heightened self-consciousness. [1] Androgenetic alopecia (AGA), which is also known as patterned hair loss (PHL) is quite a common skin condition affecting both the genders. The term "AGA" was first proposed by Orentreich. ...
Background
Androgenetic alopecia (AGA) is a multifactorial disorder expressed by several genes and various environmental factors apart from nutritional and endocrinological factors. Although association of iron deficiency (ID) as well as thyroid disorder has been evaluated in females, this is still an untouched topic as far as male pattern hair loss (MPHL) is concerned. This study tries to establish if any association of MPHL with ID and thyroid dysfunction.
Materials and Methods
This case–control study comprised 30 consecutive cases of MPHL and equal numbers of age-matched healthy controls attending dermatology outdoor department at a tertiary care hospital. Cases as well as controls were evaluated and screened for the levels of serum ferritin (SF) and thyroid-stimulating hormone (TSH). Value of SF (8–388 ng/mL) and TSH (0.358–3.7 uIU/mL) was used as standardized reference.
Results
In cases of AGA, SF level varied from 6.00 to 212.09 ng/mL (mean - 88.30 ng/mL). Whereas controls showed SF levels ranging between 23.67 and 185.05 ng/mL (mean 78.69 ng/mL). The range of TSH level in the case group was 0.379–5.078 uIU/L (mean 2.25 uIU/L), respectively, whereas control group showed serum TSH levels ranging between 0.30 and 4.30 uIU/L (mean - 1.78 uIU/L). Statistically considering two samples of equal variance P (2-tailed) for SF level was found to be 0.424, whereas 0.085 in case of TSH level depicting insignificant association. Spearman’s correlations ( P = 0.244) between alopecia grade and SF level were found to be statistically insignificant ( P = 0.193). Similarly, the P value calculated for the alopecia grade and serum TSH was 0.784, making the correlation between alopecia and serum TSH as insignificant.
Conclusion
The study found no statistically significant difference in the SF level and TSH level of the cases as compared to controls.
... Transient alopecia occurs approximately 2 to 3 weeks after commencing RT and usually resolves within 3-6 months [3]. RT-induced apoptosis of hair bulges containing stem cells can result in permanent alopecia, which can have deleterious psychological effects on quality of life and self-esteem [4]. ...
Purpose
The dosimetry of scalp dose was prospectively studied and correlated with alopecia following conventional cranial irradiation in primary brain tumors patients.
Materials and methods
Patients with primary brain tumors who required conventional radiotherapy were enrolled. A hairline marker was applied to the patient’s scalp to identify the entire scalp region. The maximal dose to 2% volume of interest (D2) for the entire scalp region were obtained. The radiation dosages at the localized hair-loss areas were evaluated during the final week of RT (transient alopecia) and six months after completing RT (permanent alopecia). Kruskal-Wallis tests were used to compare the dosimetric parameter values with statistical significance set as p < 0.05.
Results
Forty-eight patients were included in the analysis. The prescribed radiation doses ranged from 50.4 to 60.0 Gy. Thirty-two patients experienced alopecia (27 transient and 5 permanent). The median D2 values adjusted for the entire scalp were higher in the alopecia group (38.40 Gy for transient alopecia and 47.84 Gy for permanent alopecia vs 11.90 Gy for no alopecia, p < 0.001). The D2 value was determined as a predictive parameter for alopecia. The threshold values for transient and permanent alopecia over the entire scalp were 22.15 Gy and 36.81 Gy, respectively. At the localized hair-loss areas, the D2 values for transient and permanent alopecia were higher at 44.82 Gy and 50.00 Gy, respectively. The radiation intensity at the localized hair-loss areas was also related to the severity of alopecia, with D2 values of 35.14 Gy and 46.39 Gy for clinically assigned grade 1 and grade 2 transient alopecia, respectively, with the D2 value being even higher for permanent alopecia.
Conclusions
The D2 parameter value could be used to predict the type and severity of alopecia.
... The causes of hair loss are multifaceted, in uenced by factors such as irregular sleep patterns, hormonal changes, inadequate nutrition, stress affecting sleep quality, chemical exposure from hair treatments, and underlying health conditions or medical treatments. Hair loss not only impacts appearance but can also affect self-esteem over time [2]. ...
Millions worldwide suffer from hair loss, impacting appearance and self-esteem. This study evaluates 1550nm wavelength low-level laser therapy (LLLT) for hair loss treatment, focusing on efficacy, follicle health improvement, and optimal treatment parameters. In a controlled study, 68 participants with hair loss received bi-weekly LLLT over three months. The experimental group (n = 60) also had additional maintenance therapy. Evaluations at baseline, post-treatment, and up to nine months showed significant improvement in hair loss conditions, especially in the experimental group. LLLT proves effective in enhancing scalp health and promoting hair growth, with potential as a non-invasive and safe option for managing hair loss.
... Alopecia, commonly known as hair loss, involves the shedding and miniaturization of hair follicles [12]. While hair loss may not directly threaten survival, it significantly impacts an individual's quality of life by causing psychological distress [13][14][15]. Prominent factors contributing to alopecia involve genetic elements, androgens, stress, and inflammation; however, the precise molecular mechanisms remain unclear [16][17][18][19]. Previous studies have indicated that DPCs derived from patients with androgenetic alopecia (AGA) exhibit slowed growth and premature senescence [20]. ...
Autophagy is essential for regulating hair growth. Accordingly, we developed autophagy activator ICP5249 (pentasodium tetracarboxymethyl palmitoyl dipeptide) and investigated its potential role in hair growth. We evaluated its effect on hair growth using in vitro human dermal papilla cells (hDPCs) culture model, human hair follicles (hHFs) organ culture model, and telogenic mouse model. ICP5249 increased hDPCs proliferation and alkaline phosphatase (ALP) expression. It also increased microtubule-associated protein (MAP) light chain 3- II (LC3-II) expression and AMP-activated protein kinase α (AMPKα) and unc-51-like kinase 1 (ULK1) phosphorylation in hDPCs. ICP5249 extended the length of hHFs and increased LC3 II expression. Consistently, ICP5249 also significantly increased hair growth area, dermis thickness, and anagen and telogen ratio in telogenic mice. Furthermore, it upregulated Ki-67 and LC3-II expression and AMPKα phosphorylation on the mice's dorsal skin. To investigate whether AMPK regulates ICP5249-induced hair growth, following treatment with the compound C, AMPK inhibitor, the activity of ICP5249 was evaluated. The effects of ICP5249 on hair growth were assessed following pretreatment with the AMPK inhibitor compound C. The results showed that compound C suppressed ICP5249-mediated proliferation and hair inductivity in hDPCs. Additionally, compound C inhibited ICP5249-mediated hair growth area, dermis thickness, anagen and telogen ration, and LC3-II expression in mice, suggesting that ICP5249 promotes hair growth by modulating autophagy, with AMPKα playing a regulatory role in this process. Taken together, we demonstrate that ICP5249 has the potential as an ingredient for improving hair growth.
... Congenital hypotrichosis is the most complex hair growth disorders, with several distinctive entities. Hypotrichosis is a condition characterised by a lack of hair in the early stages of life [5]. Autosomal dominant or autosomal recessive hypotrichosis caused by mutations in LIPH [6], LPAR6 or DSG4 [7] can be inherited in an autosomal dominant or autosomal recessive manner [8] and has a wide genetic diversity [9][10][11][12]. ...
Congenital hypotrichosis is a major genetic disorder of hair-growth that affects millions of people all around the world. In this study, hypotrichosis was studied in the affected families in the district of Sahiwal. A wide survey was conducted in both rural and urban areas of district Sahiwal. For additional investigation and pedigree construction, five families were selected after the survey was completed for further analyses. Verbal consent was taken from the participants to assure them that the information and data was taken with their complete willingness and harmony, without any pressure. During the survey, each family was thoroughly interrogated, and the pedigree was constructed. The pedigree analyses were used to determine the prevalence of hypotrichosis and origin of mutation in each family. A pedigree analyses of hypotrichosis-infected individuals found that the disease was handed down through generations. In each generation of infected families, some people remain unaffected showed that the disease was genetically recessive disorder. Overall prevalence of this genetic disorder was 25.82S % in the selected families. The hypotrichosis affected 55 individuals out of 213 individuals in studied families. In the current study, the prevalence of this disease varied across all reported families. The prevalence rate of the disease in UOA was 17.24%, in UOB was 20.00%, in UOC was 41.94%, in UOD was 23.40% and in UOE was 40.740% of the families. The present study concluded that hypotrichosis in the selected families were persistent for at least three generations and the mode of inheritance was autosomal recessive.
... Hair is often associated with youth, beauty, and health. For females, hair often portrays sexual attractiveness, femininity, and self-confidence (3,6). Although FPHL is a benign disorder, hair loss, even though negligible, can have a profound impact on patient's self-image, self-esteem and overall QoL (3,7). ...
This case series evaluated use of injectable platelet rich fibrin (termed i-PRF+) for the treatment of female pattern hair loss (FPHL). Eleven individuals underwent 3-monthly intradermal injections of i-PRF+ using a mesotherapy gun. The mean number of hair follicles containing hairs per unit area improved at 3- and 6-months follow-up (p < .001), and all participants had a negative hair pull test. Hair volume and thickness, and patient-reported outcome scores also improved at follow-up (p < .001). Adverse effects were minor and self-limited. A series of three i-PRF+ injection sessions were effective for the treatment of FPHL, as shown by improved hair analysis parameters and patient self-assessment scores.
... In a study by Shairquie KE, a positive hair pull test was found on 39 subjects with TE (> 10-50% with a mean number of 35%) [4]. [10]. In addition, a systematic review by Schielein lower than the control group (p = 0.025) [21]. ...
Hair disorders are often found in patients post-COVID-19 infection, with telogen effluvium (TE) as its most common type. Hair disorders have a major socio-psychological impact on society. Furthermore, vitamin D deficiency may trigger hair loss in post-COVID-19 patients. This study aims to describe the profiles and characteristics of post-COVID-19 patients with hair loss and to assess its association with vitamin D-25-OH levels and quality of life. Our study is an observational cross-sectional study that include 40 subjects aged 19–59 years with hair loss post-COVID-19 infection and have stopped taking anti-androgen or minoxidil for at least one month (from July to August 2022). The Sinclair Hair Shedding Scale was used to measure hair loss severity on hair-washing and non-hair-washing days. Trichoscopic features was also used to portray the clinical picture of hair loss. The serum level of Vitamin D-25-OH was used to determine vitamin D levels. Vitamin D The subjects’ quality of life was assessed using Dermatology Life Quality Index (DLQI) questionnaire. The results show that all subjects observed in this study were clinically diagnosed with TE and 90% being female. Onset and duration of hair loss, hair loss severity, degree of reduced quality of life, and vitamin D levels varied among subjects. There was no association between post-COVID-19 hair loss with vitamin D levels and quality of life. This study indicated an association between the presence of canities and hair loss severity. Further studies are required to confirm the theory.
... Tis is because they are more easily infuenced by magazines, the media, and the Internet, thanks to their reading skills [2,[19][20][21]. When comparing our results with the DLQI averages found in other studies, we note that the average score for quality of life impairment in our subjects was higher than that found in most other diseases [22][23][24][25][26][27][28]. ...
Introduction
The purpose of this study was to study the quality of life and psychiatric comorbidities of subjects practicing voluntary skin depigmentation in the city of Cotonou.
Methods
A cross-sectional, prospective, and analytical study, based on a three-stage probabilistic sampling method, included from June to October 2020, consenting subjects over 15 years of age, practicing artificial skin depigmentation, and residing for at least one year in Cotonou. The Dermatology Life Quality Index, Rosenberg, and Hospital Anxiety and Depression scales allowed us to evaluate the quality of life and self-esteem, and identify anxiety and depression, respectively. A p value <0.05 indicated a significant result.
Results
We included 330 subjects. The mean age was 33.6 ± 11.6 years and the sex ratio was 0.4. Impaired quality of life was observed in 93.7% of subjects. Anxiety was diagnosed in 11.2% and depression in 5.8% of them. Self-esteem was low or very low in 24.2%. The degree of quality of life and the alteration of self-esteem, and the frequency of anxiety and depression were proportional to the number of skin lesions, the lightening products used, and the monthly cost of the products.
Conclusion
The use of several lightening products exposes patients to numerous skin lesions, which are a source of impaired quality of life and whose persistence leads to psychiatric comorbidities.
... 12 Hair loss can significantly diminish overall quality of life of adult males and females with association of symptoms of clinical depression, particularly more severe in females than in males. 14,15 The test treatment used in the present study contains Sesbania grandiflora extract (commonly known as Agati) [(SesZen-Bio ® , Zywie Ventures Private Limited), Zenherb Labs Private Limited, India] which is standardised for 0.5% biotin and contains various cofactors which are used for their antioxidant, astringent, antihistaminic, anxiolytic, anticonvulsive and febrifugal activities. [16][17][18] The leaves and flowers of Agati are abundant in vitamins (biotin, A, C, B2, etc) and minerals (zinc and selenium), whereas the bark and flowers are rich in polyphenols. ...
Hair loss, a common multifactorial condition affecting both genders, results from causes like extrinsic factors (pollution, sun, humidity, and temperature), nutritional variation, or intrinsic factors such as ageing, heredity, hormonal and medical conditions. Some of the damages caused by these factors can be effectively managed with multivitamins, minerals, antioxidant natural products. Present study assessed use of standardised herbal Sesbania grandiflora extract for improving hair density, hair thickness and scalp health along with a serum biomarker to establish
the probable mechanism of action.
The study was approved by the ethics committee and was conducted as per standard national regulations. 51 randomized subjects (mean age: 39.40±5.80 years) received either test-treatment or placebo for consecutive 56 days. Instrumental assessments included a phototrichogram to assess hair density, thickness, and scalp condition.
SesZen-BioTM which is derived from Sesbania grandiflora extracts showed an improvement in hair density, hair thickness and ferritin in 8 weeks of usage suggesting it stimulates the keratin production which resulted in improved follicle growth. By day 56 of usage, hair density and thickness improved by 58.92±28.69 cm2 and 3.68±2.69 μm respectively from baseline (both p<0.0001) in the treatment group. This indicates towards 25% improvement in hair density, 16.94% in hair thickness and almost 72% volunteers indicated an improvement in hair health along with 27%
increase in serum ferritin.
Sesbania grandiflora extract -SesZen-Bio® showed beneficial nutritional effects on research subjects, proving its usefulness as a well-tolerated and efficient daily supplement to improve hair health.
... Alopecia, hair loss or hair shedding, has a significant impact on the quality of life, especially in women, and has various etiologies, including hormone dysregulation, diet, autoimmune conditions, psychiatric disorders, or other underlying disease. 1,2 Further, alopecia may be a rare unintended outcome of medication use, except for anti-cancer chemotherapy. 3,4 Claims data are the preferred data source for studying infrequent health outcomes of medication use because of their size, their longitudinal recording of medication use and outcomes, and their reflection of routine clinical practice, including a variety of patient groups under-represented in clinical trials. ...
Background: Accurately identifying alopecia in claims data is important to study this rare medication side effect.
Objectives: To develop and validate a claims-based algorithm to identify alopecia in women of childbearing age.
Methods: We linked electronic health records from a large healthcare system in Massachusetts (Mass General Brigham) with Medicaid claims data from 2016 through 2018 to identify all women aged 18 to 50 years with an ICD-10 code for alopecia, including alopecia areata, androgenic alopecia, non-scarring alopecia, or cicatricial alopecia, from a visit to the MGB system. Using eight predefined algorithms to identify alopecia in Medicaid claims data, we randomly selected 300 women for whom we reviewed their charts to validate the alopecia diagnosis. Positive predictive values (PPVs) were computed for the primary algorithm and seven algorithm variations, stratified by race.
Results: Out of 300 patients with at least 1 ICD-10 code for alopecia in the Medicaid claims, 286 had chart-confirmed alopecia (PPV = 95.3%). The algorithm requiring two diagnosis codes plus one prescription claim for alopecia treatment identified 55 patients (PPV = 100%). The algorithm requiring 1 diagnosis code for alopecia plus 1 procedure claim for intralesional triamcinolone injection identified 35 patients (PPV = 100%). Across all 8 algorithms tested, the PPV varied between 95.3% and 100%. The PPV for alopecia ranged from 94% to 100% in White and 96%–100% in 48 non-White women. The exact date of alopecia onset was difficult to determine in charts.
Conclusion: At least one recorded ICD-10 code for alopecia in claims data identified alopecia in women of childbearing age with high accuracy.
... Misdiagnosis and inadequate treatment can augment the psychosocial burden and poor quality of life outcomes in CCCA. [39][40][41] Thus, it is important for dermatologists to maintain high clinical suspicion of nontypical CCCA presentations to improve patient outcomes and reduce disease burden. ...
... After the anagen phase, there is a 3-week period known as catagen, during which programmed cell death occurs (Majeed et al., 2020). Following catagen, the hair enters a resting phase called telogen, which lasts for about 3 months (Williamson and Gonzalez, 2001). Compared to anagen hairs, telogen hairs are positioned higher in the skin and can be easily pulled out. ...
Hair loss in adult men albeit common, can cause emotional distress. Many people with hair fall issues try chemical-based treatments that may lead to health complications and allergic reactions. Cosmetics using natural ingredients derived from plants have fewer side effects compared to synthetic alternatives. The study aimed to formulate herbal hair oil using various ingredients like castor oil, sunflower oil, jojoba oil, olive oil, pumpkin oil, etc. and evaluate its effectiveness in promoting hair growth and prevention of hair fall (HG-HF). Besides, the oil was supposed to provide a range of benefits for hair health, including preventing dandruff, improving scalp health, providing antioxidant properties, and thereby protecting against oxidative damage. The DPPH radical scavenging test was done to evaluate the antioxidant activity of the oils. Varying IC50 values were found such as olive oil and sunflower oil showed IC50 values of 3.79 μg/ml and 4.44 μg/ml respectively. Hence, these oils have significant antioxidant activity with a strong ability to scavenge or neutralize free radicals. A study was conducted on sixteen volunteers with hair loss, dandruff, and other hair problems to check the performance of the oil. 56.25% of the participants experienced increased hair growth and 50% reported a decrease in hair fall after using the oil for 3 months, with no remarkable side effects. Data demonstrated effectiveness and overall acceptable perception of the HG-HF oil by the participants. Bangladesh Pharmaceutical Journal 27(1): 9-18, 2024 (January)
... Entrepreneur's pattern hair loss (PHL) was selected as endogenous source of variance and, thus, represents the instrument variable. PHL is the most common type of hair loss among men and strongly correlates with attractiveness ( Van der Donk et al., 1994;Muscarella and Cunningham, 1996;Williamson et al., 2001). Hair loss has psychosocial effects by making people more self-conscious and dissatisfied with their appearance (Girman et al., 1998;Budd et al., 2000;Alfonso et al., 2005;Cash, 2009), potentially causing negative self-image and lower selfesteem. ...
Financial risk-taking is central to venture capital decision-making, which is increasingly approached from a heuristics and biases perspective. While previous research has identified entrepreneurs’ physical attractiveness as an important heuristic cue in VCs’ investment decisions, this study addresses the role of VCs’ own physical attractiveness in relation to the financial risks they take. Using a dataset for a representative sample of 341 male entrepreneur and male VC dyads in the context of stage financing, this study finds that VCs of below-average attractiveness are more sensitive to the physical attractiveness of the entrepreneur when compared to VCs of average attractiveness. Also, the nature of this effect changes from the first to the second investment round for VCs of below-average attractiveness. Combined, these findings imply that VCs’ funding decisions may be subject to mechanisms that stem from their own physical attractiveness. Theoretical implications for VC decision-making and same-sex stimuli are discussed.
... Alopecia is characterized by hair loss mainly on scalp. It does not have many physically harmful effects, but psychological wellness and overall quality of life is impacted in individuals suffering from hair loss (1,2). The most common form of hair loss is androgenetic alopecia, affecting men and women at different ages (3,4). ...
Androgenic alopecia is the most common form of hair loss, affecting men and women at different ages. The role of natural bioactive compounds has gained increasing recognition as a potential means to address hair loss. There is great interest in oligomeric procyanidins, particularly procyanidin B2, which have been shown to possess hair-growing activity. Annurca (Malus pumila Miller cv Annurca) apple fruits have one of the highest amounts of oligomeric procyanidins, specifically of procyanidin B2, compared to more common apple cultivars. In this study, randomized double-blind controlled parallel group trial was performed to compare the efficacy of the Annurca apple fruit extract as nutraceutical AT HAIR-FUL AA® food supplement with a placebo in hair growth. AT HAIR-FUL AA® procyanidin B2 whole fruit (peel and pulp) is characterized by a complex mixture of polyphenolic compounds, especially chlorogenic acid (400 - 600 μg/g) and procyanidin B2 (60-100 μg/g). The products were assigned to 80 enrolled subjects with alopecia, divided into 2 groups: 40 subjects took AT HAIR-FUL AA® food supplement and 40 subjects took the alternative treatment (PLACEBO). Each group of volunteers underwent 180 days of treatment, with the intake of 2 capsules per day. After that, volunteers took nothing for 30 consecutive days (follow up). The AT HAIR-FUL AA® food supplement significantly affected hair loss: hair density and weight significantly increased and hair loss significantly decreased over time (p<0.001). Moreover, we observed a fairly good pleasantness and a good skin and gastro-intestinal tolerability of the product, confirming its compliance of use: the product did not have a significant effect on gastrointestinal disorder and stomach ache onset (p=0.41 and p=0.25, respectively). AT HAIR-FUL AA® food supplement could be used as potential agent to induce hair growth.
... Furthermore, skin conditions may aect other important factors, such as opportunities in nding partners, the ability to perform specic tasks, and professional capabilities. Acne vulgaris, vitiligo, hair loss, as well as conditions such as psoriasis or atopic dermatitis that can aect the entire body, are among skin conditions that have been known to most negatively impact QOL and self-image, including those that are related to the visible areas of the skin [8,9]. For women, dealing with skin disease(s), this can be a daily struggle. ...
This study aims to assess the inuence of vitiligo illness on the quality of life of female individuals residing in Ajda-biya, Libya. Through this investigation, we aim to enhance our comprehension of the potential impact of cultural norms and conventional gender roles on managing and caring for skin disorders within a North African society. Over a 20-week period, 65 female participants diagnosed with vitiligo were recruited. The participants' quality of life was assessed using the Skindex-16 scale. This validated tool measures the impact of skin disease on several aspects of an individual's life, including physical, emotional, and social well-being. The ndings of this study indicate that the quality of life of women with vitiligo signicantly diered with age, social and functional status, and economic status. However, the illness profoundly impacted patients' lives emotionally, with clear consequences, including diminished emotional satisfaction and reduced social participation. The results of this study highlight the negative eects that vitiligo disease can have on women's quality of life within traditional Libyan society. This investigation also indicates that cultural norms and traditional gender patterns may contribute to these eects.
... 고 하였다. 다른 선행연구들을 살펴보면, 탈모에 대 한 자의식은 고조되고 낮은 자신감과 낮은 자존감으로 삶의 질 이 낮아지며, 특히 초기 탈모 증상이 삶의 질과 유의미한 상관 을 가진다(Lee, 2016;Williamson et al, 2001). 남성형 탈모로 내 원한 환자를 대상으로 한 연구에서는 자신의 외모에 90% 이상 이 불만족하며 탈모로 인하여 사회생활에 지장을 받는 경우도 과반수 이상으로 보고되었다(Lee, 2016; Kim & Sim, 2001). ...
The rich modern life caused hair loss in many people, and they began to take care of hair loss, worrying about their appearance that changed due to hair loss. The purpose of this study is to study the effect of appearance awareness formed by hair loss on hair loss management behavior through psychological factors. For the study, a survey was conducted focusing on residents in the Seoul metropolitan area who have experienced hair loss or are experiencing hair loss. A survey was conducted from May 15, 2023 to June 30, 2023, and 296 copies were used for statistical analysis. Frequency analysis, factor analysis, reliability analysis, correlation analysis, multiple regression analysis, and mediated regression analysis were conducted using SPSS 25.0. As a result of the study, it was confirmed that appearance awareness by hair loss had a positive (+) effect on hair loss management behavior in self-awareness, but a negative (-) influence relationship appeared in appearance management intention. It was confirmed that appearance awareness had a positive (+) effect on psychological factors and psychological factors on hair loss management behavior. As a result of research on the mediating role of psychological factors in the relationship between appearance awareness and hair loss management behavior, it was found that self-awareness, a sub-factor of appearance awareness, was completely mediated for basic care and partially mediated for active care. Appearance management intention was dismissed because it did not show an influence relationship between basic care and active care. Based on the results of this study, more diverse studies are expected to be conducted, and if consumers' psychological discomfort and pain are understood in depth during hair loss management and treatment at the management and treatment site, the best synergy effect can be achieved.
... To better characterise how hair loss affects the lives of patients, several standardised tests have been created for clinicians to administer to patients. [41][42][43][44] Here, the authors highlight two studies that are most commonly used in clinical settings. ...
The psychosocial impact of alopecia on the quality of life of patients underscores the importance of dermatologist readiness to evaluate this common chief complaint. When evaluating a patient presenting with new-onset hair loss, the differential diagnosis may be broad, encompassing many subtypes of hair loss. Each type of scarring or non-scarring alopecia presents with its own unique aetiology, epidemiology, clinical presentation, trichoscopic findings, and laboratory studies. Further, accurate diagnosis is needed to determine appropriate therapeutic management. This review provides a systematic approach for dermatologists to use in order to accurately diagnose hair loss disorders, including clinical examination, laboratory evaluation, and specialised tests.
... Most of the interviewed patients (78%) associated the decrease of self esteem, the isolation tendency, depression, anxiety not with alopecia itself, but with the fact that the hairless areas are visible. They use various defensive strategies to conceal their discontents; they "conceal" them under hats, scarves, they spend a long time in front of the mirror styling their hair or they avoid certain situations (strong lighting at the head level) or certain activities (swimming) that could highlight their issue in society (33,34). ...
... Androgenetic alopecia is an androgen-dependent polygenic genetic disease of hair loss, accounting for about 90% of the total number of people with hair loss (Desmond J. Tobin, 2005). The onset of hair loss does not damage the physical health of the patient, but it brings serious mental stress and psychological burden to the patient (D Williamson, 2001;THOMAS F. CASH, 2001). Currently, there are many drugs and treatments for androgenetic alopecia. ...
Androgenetic alopecia (AGA) is the most common type of hair loss, in which patients mostly present with a state of a receding hairline on the forehead. It brings a great mental burden to the patient. Androgenetic alopecia is caused by the combination of dihydrotestosterone (DHT) and androgen receptors (AR), disrupting the hair follicle cycle and minimizing hair follicles. The major treatments currently available include finasteride, minoxidil, hair transplantation, Platelet-rich plasma (PRP), stem cell therapy, etc. This article reviews the mechanism of AGA and the existing major treatments. The author suggested that androgen receptor degrader drugs have good prospects for application among those of various therapeutic options.
... After the anagen phase, there is a 3-week period known as catagen, during which programmed cell death occurs (Majeed et al., 2020). Following catagen, the hair enters a resting phase called telogen, which lasts for about 3 months (Williamson and Gonzalez, 2001). Compared to anagen hairs, telogen hairs are positioned higher in the skin and can be easily pulled out. ...
... It is reported that about 50% of men and 15-30% of women are affected by hair loss and the psychological burden it carries. Furthermore, its prevalence also seems to be increasing rapidly [2,3]. Based on its causes and symptoms, hair loss can be divided into three types: androgenetic alopecia (AGA), alopecia areata (AA), and other types of hair loss. ...
Today, about 50% of men and 15–30% of women are estimated to face hair-related problems, which create a significant psychological burden. Conventional treatments, including drug therapy and transplantation, remain the main strategies for the clinical management of these problems. However, these treatments are hindered by challenges such as drug-induced adverse effects and poor drug penetration due to the skin’s barrier. Therefore, various efforts have been undertaken to enhance drug permeation based on the mechanisms of hair regrowth. Notably, understanding the delivery and diffusion of topically administered drugs is essential in hair loss research. This review focuses on the advancement of transdermal strategies for hair regrowth, particularly those involving external stimulation and regeneration (topical administration) as well as microneedles (transdermal delivery). Furthermore, it also describes the natural products that have become alternative agents to prevent hair loss. In addition, given that skin visualization is necessary for hair regrowth as it provides information on drug localization within the skin’s structure, this review also discusses skin visualization strategies. Finally, it details the relevant patents and clinical trials in these areas. Together, this review highlights the innovative strategies for skin visualization and hair regrowth, aiming to provide novel ideas to researchers studying hair regrowth in the future.
... The association between finasteride exposure and suicidal behaviour is currently subject to scientific debate, notably on whether this association is attributable to finasteride itself, sexual adverse events secondary to finasteride treatment, or the disease treated with finasteride (particularly in the case of androgenetic alopecia) 52,53 . Our study was conducted on men treated for BPH, not for androgenetic alopecia. ...
Finasteride, a 5α-reductase inhibitor used in benign prostatic hyperplasia and androgenetic alopecia, has been associated with an increased suicidal risk, whereas it is unclear whether such risk is similar to that for another 5α-reductase inhibitor, dutasteride. We aimed to assess the risk of suicidal behaviours with finasteride relative to dutasteride. A nationwide cohort study was conducted using the French National Health Data System (SNDS). Men aged 50 years or older initiating finasteride 5 mg or dutasteride 0.5 mg in France between 01-01-2012 and 30-06-2016 were included and followed until outcome (suicide death identified from death certificate or self-harm hospitalisation), treatment discontinuation or switch, death, or 31-12-2016. Self-harm by violent means or resulting in admission to an intensive care unit were also examined. Cox proportional hazards models controlled for age and psychiatric and non-psychiatric conditions by inverse probability of treatment weighting (IPTW). Analyses were stratified according to psychiatric history. The study compared 69,786 finasteride new users to 217,577 dutasteride new users (median age: 72.0 years [Q1–Q3 = 64.5–80.2] vs. 71.1 [Q1–Q3 = 65.0–79.2]). During follow-up, 18 suicide deaths (0.57/1000 person-years) and 34 self-harm hospitalisations (1.08/1000) occurred among finasteride users versus 47 deaths (0.43/1000) and 87 hospitalisations (0.79/1000) among dutasteride users. Overall, finasteride was not associated with an increased risk of any suicidal outcome (IPTW-adjusted Hazard Ratio = 1.21 [95% Confidence Interval .87–1.67]), suicide death or self-harm hospitalisation. However, among individuals with a history of mood disorders, finasteride was associated with an increased risk of any suicidal outcome (25 versus 46 events; HR = 1.64 [95% CI 1.00–2.68]), suicide death (8 versus 10 events; HR = 2.71 [95% CI 1.07–6.91]), self-harm by violent means (6 versus 6 events; HR = 3.11 [95% CI 1.01–9.61]), and self-harm with admission to an intensive care unit (7 versus 5 events; HR = 3.97 [95% CI 1.26–12.5]). None of these risks was significantly increased among individuals without a psychiatric history. These findings do not support an increased risk of suicide with finasteride used in the treatment of benign prostatic hyperplasia. However, an increased risk cannot be excluded among men with a history of mood disorder, but this result based on a limited number of events should be interpreted with caution.
... FD has a major impact on patients' quality of life (7) and there is limited effective therapy. Currently, antibiotics are the most commonly used treatment (8), particularly tetracyclines and the combination of clindamycin and rifampicin, which has shown clinical efficacy in some cases. ...
Folliculitis decalvans is a chronic inflammatory skin disease leading to scarring alopecia. Management of this disabling disease is difficult and no treatment is currently approved. Current knowledge regarding the pathogenesis of folliculitis decalvans suggests the benefit of using anti-tumour necrosis factor-α. This pilot study aimed to evaluate the clinical efficacy of anti-tumour necrosis factor-α for management of folliculitis decalvans. A single-centre retrospective pilot study included patients with refractory folliculitis decalvans treated by tumour necrosis factor-α inhibitors. An Investigator's Global Assessment (IGA) score was designed and validated to assess the efficacy of the therapy. Response to treatment was considered good to excellent when an IGA ≤ 2 was obtained at month 12. Eleven patients were included, with a mean time from diagnosis of folliculitis decalvans to the introduction of infliximab (n = 9) or adalimumab (n = 2) of 8.55 ± 1.26 years. Nine patients had failed on at least 2 lines of systemic therapies before starting anti-tumour necrosis factor-α. The median IGA score at baseline was 3. At the end of follow-up, 5 patients were considered responders. Overall, the safety profile of anti-tumour necrosis factor-α was good. The results suggest that the clinical benefit of anti-tumour necrosis factor-α is obtained after at least 6 months of treatment. However, further prospective studies are needed to confirm these results.
Performance‐enhancing drugs, such as testosterone, are used by athletes and youth to increase muscle growth and strength, particularly among males. However, these therapies potentially pose health risks, including liver toxicity, gynecomastia, and hair loss. Testosterone use is rising for performance enhancement, physical appearance, and resistance training, but there remains an absence of standardized guidelines for safe dosages. This study examines the relationship between testosterone use and hair health in males, aiming to develop guidelines for safe, responsible testosterone use. Understanding treatment outcomes in this context is crucial for informed healthcare.
This study systematically analysed peer-reviewed publications describing validation aspects of the Dermatology Life Quality Index (DLQI) and used Naicker’s Critically Appraising for Antiracism Tool to assess risk of racial bias. Seven online databases were searched from 1994 until 2022 for articles containing DLQI validation data. Methodology followed PRISMA guidelines, the protocol was registered in PROSPERO, and articles reviewed independently by two assessors. Of 1,717 screened publications, 207 articles including 58,828 patients from > 49 different countries and 41 diseases met the inclusion criteria. The DLQI demonstrated strong test–retest reliability; 43 studies confirmed good internal consistency. Twelve studies were performed using anchors to assess change responsiveness with effect sizes from small to large, giving confidence that the DLQI responds appropriately to change. Forty-two studies tested known-groups validity, providing confidence in construct and use of the DLQI over many parameters, including disease severity, anxiety, depression, stigma, scarring, well-being, sexual function, disease location and duration. DLQI correlation was demonstrated with 119 Patient Reported Outcomes/Quality of Life measures in 207 studies. Only 15% of studies explicitly recruited minority ethnic participants; 3.9% stratified results by race/ethnicity. This review summarizes knowledge concerning DLQI validation, confirms many strengths of the DLQI and identifies areas for further validation.
This study reviewed the current knowledge on the epidemiology, pathophysiology, clinical presentations, diagnosis, treatment, quality-of-life assessment and recent trends in androgenetic alopecia (AGA). Relevant articles on AGA from PubMed, Google Scholar, Medline and Scopus from 1950 to 2024 were obtained and scrutinized.. Key search words included each term like ‘androgenetic alopecia’, ‘androgenic alopecia’, ‘pattern baldness’ and ‘pattern hair loss’ AND each term like ‘epidemiology’, ‘pathophysiology’, ‘genetics’, ‘hormones’, ‘micronutrient’, ‘stress and inflammation’, ‘growth factors’, ‘clinical features’, ‘staging’, ‘cardiovascular associations’, ‘diagnosis’ and ‘management’ were used in the search. AGA is a non-scarring hair loss that is exemplified by a progressive decline of hair follicles, or non-functional or dead hair follicles in the scalp in a defined pattern. It is the most common hair loss, more common in men but can also present in younger age as premature AGA. Hormones, genetics, micronutrient deficiency, microinflammation and stress have been implicated, while psychosocial distress and cutaneous correlate of cardiovascular diseases have become sources of relentless research. AGA is a patterned hair loss that is more prevalent in Men. It results from the interactions between hormonal, genetic and other factors which determine the extent of hair loss and associated disorders (psychosocial and cardiovascular). As results of more research become available, the extent of AGA, its comorbidities as well as the full spectrum of their manifestations will continue to be sources of health education and more holistic examination by dermatologists and patients.
The changes in human lifestyle over the past few decades have impacted the prevalence of skin diseases within different societies. Skin diseases may result in various physical and mental disorders. The most common mental disorders observed among the patients are stress, anxiety, and depression. This study aims to investigate the global prevalence of anxiety, depression, and stress in patients with skin diseases. In this Systematic Review and Meta-Analysis study, the PubMed, Scopus, Science Direct, Embase, Web of science, and Google Scholar repositories were searched without a lower time limit. Heterogeneity among the identified studies was examined using the I² index, and accordingly random effects model was adopted for analysis. Data analysis was conducted within the Comprehensive Meta-Analysis software (v. 2). In total, 113 studies were included for the final analysis. The overall pooled prevalence of stress, depression, and anxiety in skin disease patients was found to be 39.4%, 27.2% and 28.8%, respectively. Among patients with psoriasis, acne, vitiligo or atopic dermatitis diseases, the highest number of patients suffering from stress was related to patients with acne (75.7%). The highest prevalence of depression, and anxiety was reported in patients with vitiligo (38.3%) and acne (36.5%), respectively. Considering the high prevalence of mental disorders among patients with skin diseases and recognising the impacts of mental health challenges on patients’ well-being, the findings of this study provide valuable insights for identifying specific populations that require targeted interventions for the diagnosis, treatment, and prevention of mental illnesses. Accordingly, healthcare policymakers should incorporate psychological treatment and support measures as integral components of comprehensive care strategies for patients with skin diseases.
Introduction
To understand the experiences of adolescent and adult patients living with alopecia areata (AA) in Australia regarding symptom severity and the impact on psychosocial well‐being and work/classroom productivity.
Materials and Methods
A cross‐sectional online patient survey among adolescent and adult patients diagnosed with AA was recruited via the Australia Alopecia Areata Foundation. Patient‐reported outcomes were also assessed.
Results
A total of 337 patients (49 adolescents; 288 adults), with a mean ± standard deviation age of 14.7 ± 1.55 and 38.9 ± 13.31 years for adolescents and adults, respectively, were included. In the group with extensive hair loss (Scalp Hair Assessment Patient‐Reported Outcome, categories 3 + 4, n = 172), we observed higher emotional symptom and activity limitation scores (Alopecia Areata Patient Priority Outcomes, emotional symptoms: adults 2.5 ± 1.03, adolescents 2.2 ± 1.15; activity limitations: adults 1.4 ± 1.15, adolescents 1.2 ± 0.99). Additionally, in adults, the Alopecia Areata Symptom Impact Scale global score was 4.0 ± 2.10 (symptoms subscale score 4.1 ± 1.91; interference subscale scores 3.8 ± 2.73). Hospital Anxiety and Depression Scale scores were high across participants, irrespective of hair loss extent (adults: anxiety 9.2 ± 3.85, depression 6.6 ± 3.95; adolescents: anxiety 9.7 ± 4.65, depression 5.2 ± 3.59). Work and classroom productivity were substantially impaired due to AA, with 70.5% of adults and 57.1% of adolescents reporting activity impairment, and overall work/classroom impairment reported at 39.2% and 44.9%, respectively.
Conclusions
AA impacts the physical, emotional and psychosocial well‐being of both adult and adolescent patients. More extensive hair loss more profoundly impacts those living with AA. Patients may benefit from patient‐centred care approaches addressing the impact of hair loss on mental and emotional well‐being, daily activities and work productivity.
Objectives
Cutaneous diseases that disproportionately affect patients with darker pigmentation and their histologic features are historically understudied and undertreated. This review article aims to highlight the key clinical features, histopathology, and diagnostic pearls of several cutaneous diseases that commonly present in patients with darker pigmentation.
Methods
A literature search was conducted, and a list of cutaneous diseases that frequently affect patients with darker pigmentation was compiled. A group of experts expounded upon those that were most common or misdiagnosed according to scientific evidence and clinical practice.
Results
The diseases were divided into hypopigmented disorders, hyperpigmented disorders, scarring disorders, and alopecic disorders. Within each category, the etiology, clinical features, histopathology, and key histologic differential diagnoses are described and discussed.
Conclusions
As many clinicians are taught that there are no effective treatment options or that these diseases are considered “cosmetic” in nature, patients often do not get a thorough medical workup or skin biopsy. This article aims to decrease the knowledge gap and serve as a resource for anyone involved in the care of patients with these cutaneous conditions.
This chapter reviews acquired hair disorders, including common scarring and non‐scarring alopecia presentations, conditions characterised by excessive body hair growth and acquired hair shaft disorders. We also describe the biology of normal hair follicles, including structure, hair cycle control and immunity, to better understand the mechanisms underlying these conditions. We present methods for clinical assessment, recommended investigation and management of each disease, and present summaries of frequently used therapeutics and cosmetic options employed when treating these problems.
Phloroglucinol (PG) is one of the abundant isomeric benzenetriols in brown algae. Due to its polyphenolic structure, PG exhibits various biological activities. However, the impact of PG on anagen signaling and oxidative stress in human dermal papilla cells (HDPCs) is unknown. In this study, we investigated the therapeutic potential of PG for improving hair loss. A non-cytotoxic concentration of PG increased anagen-inductive genes and transcriptional activities of β-Catenin. Since several anagen-inductive genes are regulated by β-Catenin, further experiments were performed to elucidate the molecular mechanism by which PG upregulates anagen signaling. Various biochemical analyses revealed that PG upregulated β-Catenin signaling without affecting the expression of Wnt. In particular, PG elevated the phosphorylation of protein kinase B (AKT), leading to an increase in the inhibitory phosphorylation of glycogen synthase kinase 3 beta (GSK3β) at serine 9. Treatment with the selective phosphoinositide 3-kinase/AKT inhibitor, LY294002, restored the increased AKT/GSK3β/β-Catenin signaling and anagen-inductive proteins induced by PG. Moreover, conditioned medium from PG-treated HDPCs promoted the proliferation and migration of human epidermal keratinocytes via the AKT signaling pathway. Subsequently, we assessed the antioxidant activities of PG. PG ameliorated the elevated oxidative stress markers and improved the decreased anagen signaling in hydrogen peroxide (H2O2)-induced HDPCs. The senescence-associated β-galactosidase staining assay also demonstrated that the antioxidant abilities of PG effectively mitigated H2O2-induced senescence. Overall, these results indicate that PG potentially enhances anagen signaling and improves oxidative stress-induced cellular damage in HDPCs. Therefore, PG can be employed as a novel therapeutic component to ameliorate hair loss symptoms.
In recent decades of significant development in the world, a new perspective direction of integration of psychosomatic medicine and psychiatry/medical psychology, which is focused on the study of interaction between psyche and skin, is psychodermatology. Among topical psychodermatological problems, special attention is paid to the peculiarities of the psycho-emotional sphere in different types of alopecia, because, even in the light of socio-cultural features, in most societies, hair is an important component of attractiveness, and its pathology can have serious psychological and even psychiatric. Analysis of the state of the problem in this field has proved that the presence of alopecia is a powerful factor that has a negative impact on the mental state and quality of life of the patient. The presence of alopecia is associated with high levels of depression and anxiety, as well as with worse social functioning and lower quality of life. This requires additional research and development of personalized therapeutic and rehabilitation measures for eliminate the negative psychiatric consequences of alopecia
Congenital and inherited disorders of hair growth and differentiation, also known as genotrichoses, can be subdivided into conditions associated with either excessive hair growth, known as hypertrichoses , or defective hair development or alopecias . Some of these disorders feature isolated hair abnormalities, others are associated with extracutaneous manifestations and as such require careful surveillance or timely interventions for possible complications.
Astragalus membranaceus and Cinnamomum cassia are used as spices and flavorful ingredients, or medicinal herbs with pharmacological effects. In this study, the hair-growth-promoting effects of the YH complex, a newly developed formula consisting of membranaceus and C. cassia, are investigated with the prediction of its molecular mechanism. The target gene of the YH complex was about 74.8% overlapped with the gene set of ‘Hair growth’ on the GO Biological Process database. The oral administration of the YH complex promoted hair regrowth and increased hair-shaft thickness in depilated hair loss mice. In addition, the anagen/telogen hair follicle ratio was significantly increased by the YH complex. The growth factors affecting the growth of hair follicles were dose-dependently increased by treatment with the YH complex. The Wnt/β-catenin signaling pathway expressions in skin tissues were apparently increased by the administration of the YH complex. In conclusion, the YH complex consisting of A. membranaceus and C. cassia induced hair follicle differentiation and preserved the growing-anagen phase by increasing growth factors and the Wnt/β-catenin signaling pathway, leading to the restoration of hair loss. The YH complex can be a remedy for hair loss diseases, such as alopecia areata, androgenetic alopecia, telogen effluvium, and chemotherapy-induced alopecia.
Introduction:
Androgenic alopecia (AGA) is the most common cause of hair loss in women, affecting their quality of life. The present study was conducted with the aim of comparing the combined effect of topical minoxidil and oral spironolactone with the combined effect of topical minoxidil and oral finasteride in women with AGA, female and male hair loss patterns.
Method:
This clinical study was performed on 60 women suffering from AGA. The patients were divided into two groups receiving spironolactone 100 mg/day and finasteride 5 mg/day. In addition, a 2% minoxidil solution was used in all patients in addition to treatment with finasteride or spironolactone. At 2 months after initiation and at the end of treatment, patients were evaluated using the Ludwig/Norwood-Hamilton scale and the degree of physician and patient satisfaction.
Results:
After 2 months, hair density, hair thickness, and hair loss had improved in both groups; however, statistically, there was no significant difference between the two groups with respect to these parameters (p > 0.05). After 4 months, a significant difference was found between the two groups in terms of treatment response (physician satisfaction), hair density, and hair loss severity. So that, the drugs used were ineffective in 6.7% of cases in the minoxidil-spironolactone group and in 16.7% of cases in the minoxidil-finasteride group. In addition, 43.3% of cases in the minoxidil-spironolactone group and 53% in the minoxidil-finasteride group responded well to treatment. The treatment effect was excellent in 56.7% and 0% of the mentioned groups, respectively, and the mentioned difference was statistically significant (p: 0.01). The response to treatment in female pattern hair loss (FPHL) was not statistically significant (p: 0.52), but there was a significant difference in the response to both treatments in male pattern hair loss (MPHL; p: 0.007). In terms of patient satisfaction, minoxidil-spironolactone treatment was significantly better than minoxidil-finasteride regarding hair density and severity of hair loss (p: 0.01). Finally, in terms of treatment complications, the patients in two groups did not have any serious adverse effects.
Conclusion:
The combination of minoxidil and spironolactone could be considered a more effective treatment than the combination of minoxidil and finasteride in women with AGA, FPHL, and MPHL.
Inherited hair disorders form a highly phenotypically and genetically heterogeneous group, which result from abnormal regulation of hair growth and differentiation leading either to excessive or defective hair follicle development. Accurate diagnosis is essential as many of these disorders are indicative of sometimes occult and/or delayed systemic manifestations.
Cicatricial alopecia may lead to an enormous emotional burden, social distress, and psychological impairment affecting the quality of life. The objective of this review is to systematically describe the health-related quality of life in adults with primary cicatricial alopecia and its subtypes. Studies that (i) reported quality of life in patients with primary cicatricial alopecia or its subtypes; (ii) were original research and not a conference abstract or review (iii) with patients >18 years of age were included in the review. The studies not mentioning quality of life specifically for the cicatricial alopecia cohort were excluded. We searched for literature via OVID in Medline and Embase, in Web of Science, CINAHL, EBSCO (APA PsycArticles, APA PsycInfo, and PSYNDEX Literature), in the Cochrane Library and for grey literature from its inception date till 12.11.2022. The risk of bias was assessed by using the AXIS tool for cross-sectional studies by two independent authors. Thirteen observational cross-sectional and one single-arm study, including 572 patients and eight different instruments, fulfilled the inclusion criteria. Results are descriptively synthesized, and associated factors of quality of life are presented. The data from studies that used the Dermatology Life Quality Index tool (DLQI) showed that more than 70% of the patients have an impaired life quality. While trichodynia and anxiety have a negative effect on the quality of life, disease duration, education, employment, and marital status have no effect. The findings were inconsistent for other factors. Most of these studies failed to justify the sample size. Furthermore, the risk of bias assessment could not surely rule out a non-response bias. Our results suggest that cicatricial alopecia treatments must be integrated with psychosocial intervention and indicate the need for further research with homogenous and more comprehensive tools to identify and address this patient population's unmet mental health needs.
Genetic hair disorders, also known as genotrichoses, are characterized by abnormalities of hair structure, growth, or differentiation, giving rise to a spectrum of phenotypes such as hypertrichosis, hypotrichosis and atrichia. These disorders may present as isolated phenotypes or be part of more complex phenotypes including abnormalities in skin or other organs. Genetic discoveries for hair disorders have been recently augmented with the advent of next-generation sequencing (NGS) technologies. We reviewed the literature and summarised disease-gene associations for inherited hair disorders, as well as genodermatoses presenting with hair abnormalities discovered by NGS technologies. We identified 28 non-syndromic hair disorders, involving 25 individual genes and four unidentified genes. We have also discovered that approximately 30% of all genodermatoses that were identified by NGS approaches demonstrated hair abnormalities as part of their phenotype. This review underscores the huge impact of NGS technologies in disclosing the genetics of hair disorders and the potential the discoveries provide for future translational research and new therapies.
Androgenetic alopecia (AGA) is the most common type of progressive hair loss in both men and women that severely reduces life quality and affects patients' self-esteem. Due to the shortcomings of traditional therapeutic formulations (e.g., topical minoxidil and oral finasteride), such as low bioavailability, frequent dosing, and significant side effects, there is an urgent need to develop a safe and effective strategy for AGA treatment. Here, we report a water-soluble microneedle (MN) patch integrated with biodegradable minoxidil (MXD)-loaded microspheres for long-acting AGA treatment with reduced administration frequency and improved patient compliance. When the patch pierces the skin, the MNs rapidly dissolve and deliver MXD-encapsulated polylactic-co-glycolic acid (PLGA) microspheres into the skin, which, subsequently act as drug reservoirs for the sustained release of the therapeutics for over 2 weeks. Additionally, the application of the MN patch provided a mechanical stimulation on mouse skin, which was also helpful for hair regrowth. Compared with the topical MXD solutions that have been commercialized on the market and require daily application, the long-acting MN patch contains a much lower drug amount and shows a similar or superior hair regeneration effect in AGA mice while only requiring monthly or weekly administration. These encouraging results suggest a simple, safe, and effective strategy for long-acting hair regeneration in clinics.
Introduction: Androgenetic Alopecia (AGA) is a progressive loss of hair in a patterned distribution for which treatment selection is limited. Long-term efficacy, safety, cost leads to low compliance rate. Among various treatment modalities (medical and surgical) available, microneedling and Platelet Rich Plasma (PRP) are emerging as a newer, useful and safe non surgical treatment regime. Aim: To evaluate the effectiveness and safety of microneedling with PRP versus minoxidil (5%) + finasteride (0.1%) topical therapy in AGA. Materials and Methods: This randomised controlled trial was done at Department of Dermatology, Venereology and Leprology (DVL), Hind Institute of Medical Sciences, Safedabad, Barabanki, Uttar Pradesh, India, from November 2021 to November 2022. Total of 60 adult males clinically diagnosed with AGA were enrolled and randomised into group 1 and group 2. Subjects in group 1 were treated with microneedling+PRP and group 2 were advised minoxidil+finasteride topical therapy. Microneedling alongwith intradermal injection of autologous PRP was done every month for four consecutive months in group 1 (n=30) while 1 mL of minoxidil (5%)+finasteride (0.1%) lotion was advised to be applied over dry scalp twice daily for four months in group 2 (n=30) patients. Both groups were followed for next two months. Hair density was assessed by Hamilton Norwood Scale using photographic and dermoscopic images and patient’s self-assessment scores. Data assessment was done by Chi-square test. Statistical Package for the Social Sciences (SPSS) version 26.0 was used to analyse data and p-value for significance was established at <0.05. Results: Patients in group 1 with mean age 27.9±4.15 years showed almost similar increase in hair density compared to group 2 with mean age 25.8±3.94 years, as assessed by patient assessment score, photography, dermoscopy, Hamilton Norwood scale at six months of study (p-value >0.05), however onset of action was quicker in group 1. Investigator assessment on improvement in hair density using Hamilton Norwood Scale at three months (p-value=0.920) and six months (p-value=0.995) showed that microneedling+PRP therapy is as effective as minoxidil+finasteride lotion since the difference between results of both groups was not statistically significant. Conclusion: Microneedling and PRP although safe, effective and promising treatment modality in AGA is comparable to minoxidil+finasteride topical therapy.
Chronic skin diseases can substantially impact a patient's physical, psychologic, and social well-being. Physicians may play a critical role in identifying and managing the psychologic sequelae of the most common chronic skin conditions. Acne, atopic dermatitis, psoriasis, vitiligo, alopecia areata, and hidradenitis suppurativa are chronic dermatologic diseases that put patients at high risk for symptoms of depression, anxiety, and decreased quality of life. Both general and disease-specific scales exist to assess the quality of life in patients with chronic skin disease, the most common being the Dermatology Life Quality Index. The general management approach to the patient with chronic skin disease should incorporate acknowledgment and validation of the patient's struggles, patient education on the potential impact of disease and prognosis; medical management of the dermatologic lesions; coaching on stress management; psychotherapy. Psychotherapies include talk therapy (i.e., cognitive behavioral therapy), arousal-reducing therapies (i.e., meditation, relaxation), and behavioral therapies (i.e., habit reversal therapy). Improved understanding, identification, and management of the psychiatric and psychologic aspects of the most common chronic skin conditions by dermatologists and other healthcare providers may positively affect patient outcomes.
Psychosocial therapies can augment standard care in dermatology, say Dr Donal Fortune and Dr Helen Richards
Derived and tested a short form of the Center for Epidemiologic Studies Depression Scale (CES-D) for reliability and validity among 1,206 well older adults (aged 65–98 yrs). The 10-item screening questionnaire, the CESD-10, showed good predictive accuracy when compared to the full-length 20-item version of the CES-D. The CESD-10 showed an expected positive correlation with poorer health status scores and a strong negative correlation with positive affect. Retest correlations for the CESD-10 were comparable to those in other studies. The CESD-10 was administered again after 12 mo. Data were based on 80% of the original sample. Scores were stable with strong correlation. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Although it is clear from the foregoing that some of the drugs and chemicals used to treat severe alopecia areata are efficacious to some degree, it is impossible to draw any meaningful comparisons among the data outlined in Tables 1 and 2. Virtually all of the studies were designed differently. Differences in chronicity and extent of disease as well as history of previous treatment resistance may significantly affect efficacy data even as two investigators compare the same drug. Drug-induced hair regrowth in alopecia areata may be very slow; a cosmetic response may take 1 to 2 years to achieve. Efficacy determinations made at shorter intervals may, therefore, not reflect true therapeutic potential. Efficacy end points vary significantly and need to be standardized. From a practical standpoint, scalp hair coverage that is deemed by the patient to be cosmetically acceptable seems to be a reasonable efficacy end point to report. Maintenance of cosmetic effect with continued treatment and/or following discontinuation of treatment also is useful to document. Table 3 outlines my approach to therapy of alopecia areata. Topical treatments often must be used for as long as 3 months before evidence of regrowth can be seen. In my experience with severe disease, if topical treatments cannot control a flare or induce regrowth, then the patient will often require either lengthy or frequent courses of systemic steroids. In my experience, prednisone doses as low as 20 mg/d may be associated with aseptic neurosis of the hip or severe gastrointestinal bleeding. Severe alopecia areata is a disease for which all therapies are, at best, palliative and, at worst, potentially harmful to patients who are usually otherwise very healthy. The psychosocial significance of this disease is enormous. The insights shared by a long-time sufferer of the disease mirror those expressed by the many patients with whom I have worked during the past 12 years. Three key elements to effectively treat the patient are (1) to help the patient understand the disease; (2) to encourage the patient to share his or her feelings with the physician, family, friends, and other sufferers of the disease; and (3) to help the patient to maintain a sense of hope for future scientific knowledge and treatment of the disease. With a thorough knowledge of the potential benefits and risks of each treatment or combination treatment, the physician with the patient's understanding and cooperation may then embark on what may be in severe cases a lengthy and sometimes unproductive therapeutic process.
Despite the prevalence of androgenetic alopecia among men, little is known about its psychological effects.
This investigation examined the psychosocial sequelae that balding men attribute to hair loss and compared balding and nonbalding men in personality functioning.
Subjects included 63 men with modest balding, 40 men with more extensive balding, and 42 nonbalding controls. All anonymously completed a battery of standardized psychological measures.
Reported effects of balding reflected considerable preoccupation, moderate stress or distress, and copious coping efforts. These effects were especially salient among men with more extensive balding and among younger men, single men, and those with an earlier hair-loss onset. Relative to controls, balding men had less body-image satisfaction yet were comparable on other personality indexes. Personality correlates of the psychological responses to hair loss were identified.
Although most men regard hair loss to be an unwanted, distressing experience that diminishes their body image, balding men actively cope and generally retain the integrity of their personality functioning.
The psychological characteristics and the hair problems of 58 females with androgenetic alopecia were compared with a group of women with non-apparent dermatological diseases, and with a group of men with androgenetic alopecia. The women with androgenetic alopecia had higher scores for self-sufficiency and social inadequacy compared to women with non-visible dermatological complaints, and they scored higher for inadequacy, rigidity and general psychological maladjustment than the men and had lower scores for injuredness self-evaluation and self-esteem. The women with androgenetic alopecia had more psychosocial problems, which they attributed to the hair loss, than the other groups.
One-hundred patients completed a questionnaire designed to assess the disability resulting from acne; patient acne severity was also graded clinically. Ten questions which correlated strongly with clinical acne severity were used to form an Acne Disability Index (ADI). This ADI correlated with the severity of facial acne (r = 0.246, P less than 0.01), chest acne (r = 0.347, P less than 0.001) and back acne (r = 0.436, P less than 0.001). Measures were made of the financial value to patients of acne treatment: when hypothetically offered either a cure for their acne or 500 pounds, 87% of patients preferred the treatment rather than the money. All 13 patients who stated a preference for the 500 pounds had minimal acne. There is no correlation between the clinical grading of acne and the amount patients would be prepared to pay for a hypothetical cure but there is a correlation between the acne disability score and the amount patients would pay (r = 0.229, P less than 0.05).
The contents and design of a psychodermatology training programs (PTP) preparing future dermatologists to cope with the psychosomatic features of their practice are discussed. This program focuses on the psychosocial factors that may provoke, precipitate, and aggravate dermatoses. It singles out the secondary illness reaction which is the result of the particular somatopsychic consequences of the visibility of dermatoses, its repercussion on the patient's body image, and on his or her social and sexual life. The benefits and the risks of a grounding in psychodermatology as well as the dermatologist's specific resistance are pointed out.
The aim of this survey was to quantify the level of handicap experienced by patients with severe psoriasis, and to assess the value that patients place on their disease using various questionnaire techniques. Dermatologists throughout the U.K. each gave a questionnaire to up to five psoriasis patients, who were either being admitted for in-patient care or were starting systemic therapy. Three hundred and sixty-nine questionnaires were completed. Of the 150 patients currently working, 59.3% had lost a mean of 26 days (SD 21.9) from work during the preceding year because of their psoriasis, and of the 180 not working 33.9% attributed not working to their psoriasis. The mean Psoriasis Disability Index (PDI) score was 38.2% (SD 23.3, n = 248), with the mean sub-scores of the 'daily activities' and 'treatment' sections being greater than those of the other three sections. Despite having severe psoriasis, the majority of patients felt that it would be worse to have diabetes, asthma or bronchitis than to have psoriasis. Forty-six, 42 and 32% considered it would be either 'better' or 'the same' to have diabetes, asthma or bronchitis, respectively. However, in those patients who also had the comparative disease, 87, 80 and 77% considered it would be 'better', or 'the same' to have the comparative disease. Forty-nine per cent of patients (n = 362) stated they would be prepared to spend 2 or 3 h each day on treatment if this might result in normal skin for the rest of the day.(ABSTRACT TRUNCATED AT 250 WORDS)
A simple practical questionnaire technique for routine clinical use, the Dermatology Life Quality Index (DLQI) is described. One hundred and twenty patients with different skin diseases were asked about the impact of their disease and its treatment on their lives; a questionnaire, the DLQI, was developed based on their answers. The DLQI was then completed by 200 consecutive new patients attending a dermatology clinic. This study confirmed that atopic eczema, psoriasis and generalized pruritus have a greater impact on quality of life than acne, basal cell carcinomas and viral warts. The DLQI was also completed by 100 healthy volunteers; their mean score was very low (1.6%, s.d. 3.5) compared with the mean score for the dermatology patients (24.2%, s.d. 20.9). The reliability of the DLQI was examined in 53 patients using a 1 week test-retest method and reliability was found to be high (gamma s = 0.99).
Quality of life and maladjustment related to hair loss were studied by means of a standardized interview in a group of 58 women with alopecia androgenetica who applied for treatment at the Department of Dermatology. The hair loss was found to have a negative influence on the quality of life on the majority of them. In 88%, hair loss had negative effects on their daily life; in about 75%, the hair problems were manifested in negative self-esteem and about 50% experienced social problems. General psychosocial maladjustment in relation to hair loss was indicated in almost one-third of the women.
Several studies have examined the psychological impact of androgenetic alopecia on men but scientific evidence is absent regarding its effects on women.
Our purpose was to determine the psychosocial sequelae of androgenetic alopecia in women and, comparatively, in men.
Subjects were newly referred patients with androgenetic alopecia (96 women and 60 men) and 56 female control patients. Subjects completed standardized questionnaires to assess their psychological reactions to their respective conditions and to measure body image, personality, and adjustment.
Androgenetic alopecia clearly was a stressful experience for both sexes, but substantially more distressing for women. Relative to control subjects, women with androgenetic alopecia possessed a more negative body image and a pattern of less adaptive functioning. Specific correlates of the adversity of patients' hair-loss experiences were identified.
The results confirm the psychologically detrimental effects of androgenetic alopecia, especially on women. The implications for patient care are discussed.
Atopic dermatitis is a chronic relapsing condition that can have considerable effects on the lives of sufferers. It is apparent that good, valid measures of life quality are necessary for quantifying the patients' perspective of the severity of their disease and the Dermatology Life Quality Index is often employed in clinical research. In a community study of atopic dermatitis we have assessed disability using the Dermatology Life Quality Index and the Patient Generated Index and compared the results from both indices. The results were significantly correlated and reflected the range of disability in patients in the community. Some items of the Dermatology Life Quality Index were not relevant for atopic dermatitis patients in the community and others, including swimming and sleep loss, were often cited in the Patient Generated Index but are not included in the Dermatology Life Quality Index. The Patient Generated Index is a novel, flexible approach to quality of life measurement that may be suitable for reflecting the wide variety of disability that is experienced by dermatological patients.
Few studies have quantified the psychosocial effects of hair loss using standardized instruments in men not seeking treatment for hair loss.
Examine self-perception of hair loss and its effects on men from the community.
Men 18-50 years of age recruited without regard to hair loss, from households near Dayton, Ohio, completed a questionnaire assessing self-perception of hair loss, satisfaction with hair appearance, hair-loss-specific effects and general health status.
Men with greater hair loss had more bother, concern about getting older, perceived noticeability to others and greater dissatisfaction with their hair appearance than men with less hair loss. These effects decreased with age for men with hair loss, but regardless of age, perceived noticeability of hair loss increased monotonically with degree of hair loss.
Men with greater hair loss report more negative effects due to their hair loss across all age groups, but the effects were more pronounced in younger men.