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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.
... 4 Loss of selfconfidence, lowered self-esteem, low personal attractiveness and social life were reported in male AGA patients. 5,6 People with alopecia are more likely to develop depression and anxiety. 6 Regardless of the extent of the reported psychosocial consequences of alopecia, each investigator used different tools, such as the Skindex-16, the Skindex-29, and the Dermatology Life Quality index and the brief COPE. ...
... 5,6 People with alopecia are more likely to develop depression and anxiety. 6 Regardless of the extent of the reported psychosocial consequences of alopecia, each investigator used different tools, such as the Skindex-16, the Skindex-29, and the Dermatology Life Quality index and the brief COPE. Among these tools, the Skindex scale was recently used to measure the QoL of patients with hair loss. ...
... The global hair specific Skindex-29 also significantly correlated with severe type AGA and younger age (< 30 years) (p＜0.01). 11 Meanwhile, Jun et al. 6 reported that AA and AGA have a significant negative impact on patient QoL. The results suggest that patients with AGA have a significantly decreased QoL. ...
Androgenetic alopecia (AGA) is a nonscarring baldness that mostly affects >50% men worldwide. Hair loss led to psychological difficulties and have a negative impact on the quality of life (QoL). This study aimed to evaluate the relationship between the type of AGA and QoL in male patients. A total of 67 male AGA patients were clinically assessed using the Hamilton-Norwood scale and interviewed using the Hair-Specific Skindex-29 scale to assess QoL. The patients were predominantly in the age group 31-50 years (50.7%), mean age 49.60 years, grade I obese (32.8%), mean BMI 24.93 kg/cm2, 41.8% with father’s AGA history, smoking (62.7%), smoking >100 cigarettes in last 6 months (41.8%), and have hypertension (16.4%) and diabetes mellitus (3%) as concomitant diseases. Based on Noorwood-Hamilton scale, the types of AGA were predominantly type II (25.4%) and followed by type III (16.4%). The results of the Hair Specific Skindex-29 on AGA patients were moderate (58.2%) and severe (41.8%). There were a relationship between AGA type and QoL (p = 0.041) and significant positive correlation between AGA type and QoL (p = 0.020, r = 0.282). In conclusion, patients experienced moderate to severe impact on QoL due to AGA. Thus, every increased in the type of AGA will impact patient’s quality of life.
Androgenetic alopecia (AGA) is a nonscarring baldness that mostly affects >50% men worldwide. Hair loss led to psychological difficulties and have a negative impact on the quality of life (QoL). This study aimed to evaluate the relationship between the type of AGA and QoL in male patients. A total of 67 male AGA patients were clinically assessed using the Hamilton-Norwood scale and interviewed using the Hair-Specific Skindex-29 scale to assess QoL. The patients were predominantly
... In our society, a head full of hair is a key component of the ideal body image. 2 Therefore, hair loss can drastically reduce body image satisfaction. 3 ...
... 30% of participants cited loss of self-confidence whereas 22.8% cited low self-esteem and more self-consciousness. 3 In another open-ended question, 40% of participants reported that their doctor had been "dismissive" or "unsupportive" and another 18.5% of participants said their doctor offered no treatment options. 3 A study by Schmidt et al. (2001) utilized the Hairdex, a tool used to measure quality of life in patients with hair loss, to assess how quality of life is affected by certain coping mechanisms. ...
... 3 In another open-ended question, 40% of participants reported that their doctor had been "dismissive" or "unsupportive" and another 18.5% of participants said their doctor offered no treatment options. 3 A study by Schmidt et al. (2001) utilized the Hairdex, a tool used to measure quality of life in patients with hair loss, to assess how quality of life is affected by certain coping mechanisms. They looked at 55 female patients who were diagnosed with androgenetic or diffuse alopecia. ...
Introduction:
Androgenetic alopecia is the most common cause of hair loss in both males and females. In a society that places significant value on hair and associates it with attractiveness, a lack there of can have damaging psychological consequences. The psychosocial impact of hair loss is often overlooked due to the medically benign nature of offending conditions. Addressing the psychological aspects of androgenetic alopecia can improve holistic patient care and patient outcomes.
Methods:
A search was conducted in PubMed using the following search strategy: androgenetic alopecia AND anxiety OR depression OR psychological OR psychosocial OR self-esteem. Studies were excluded if they focused on any other type of alopecia or were published in a language other than English.
Results:
A total of 13 studies were retained after the initial search process. The included studies date from 1992 to 2021. They all conclude that androgenetic alopecia serves as a significant psychosocial stressor in the lives of those affected. It impairs quality of life according to multiple measures.
Conclusion:
The data examined from these studies sheds light on the increased need to attend to the psychosocial comorbidity associated with androgenetic alopecia. These hair-loss patients often present to dermatology clinics to seek treatment but would also benefit from psychological support.
... Higher values indicate that the quality of life is more impaired. 13 Macroscopic photographs of the scalp were taken in standard positions: frontparietal (i.e., head down), right lateral, left lateral, and posterior. To document the extension, the AGA was classi ed as Ludwig I to III. ...
... Physicians should spend su cient time discussing therapeutic strategies with patients and allowing them to be involved in choosing treatment, as this generates greater satisfaction and adherence to treatment. According to Willianson et al, 13 40 percent of patients with alopecia were dissatis ed with their medical appointment. This might re ect a low estimate of the e ects of hair loss by health professionals, who seem unaware of feelings of vulnerability in their patients. ...
... It was found that 18.5 percent of patients felt that their doctor did not o er treatment and did not ask for exams. 13 It is important that health care professionals be trained to give appropriate support. ...
BACKGROUND: Androgenetic alopecia (AGA) is a common, genetically predisposed condition that begins after puberty and whose frequency increases with age; although biologically benign, AGA can impact patients both psychologically and socially, contributing to an impairment on their quality of life. OBJECTIVE: We sought to evaluate the psychological, social, and quality of life impairments inherent in women with AGA using 5% minoxidil daily for at least six months. DESIGN: Thirty-one women with diffuse central hair thinning and shaft miniaturization who were using 5% minoxidil daily for at least six months responded to a clinical questionnaire and underwent trichoscopy. RESULTS: 83.9 percent (n=26) of the participants reported they were satisfied with the 5% minoxidil treatment and its convenience. Hair loss influenced social life in 54.8 percent (n=17) of the respondents and choice of hair cut/hairstyle in 87.1 percent (n=27) of respondents. For 51.6 percent (n=16) hair loss was slightly increased, although it did not increase after beginning treatment. A frontoparietal pattern (74.2%, n=23), very low capillary density (61.3%, n=19), trichodynia (32.3%, n=10), and negative traction test (100%, n=31) were also observed. Miniaturization occurred in 100 percent (n=31) of patients, frontal/occipital hair thickness was reduced in 83.9 percent (n=26), and more than 10 percent of velus hair in the frontal area was observed in 83.9 percent (n=26) of patients. The number of hair shafts per follicular unit was reduced in 67.7 percent (n=21), and a higher frontal to occipital ratio of follicular units with one hair shaft was seen in 74.2 percent (n=23) of patients. Empty follicles, large numbers of peripillar brownish halo, scalp pigmentation, mild Ludwig's baldness degree, and quality of life scores of 4±3.5 points were observed. CONCLUSION: Our results indicate that patient satisfaction and quality of life of women with AGA on 5% topical minoxidil are high, although hair loss influences daily habits and social life.
... It has been demonstrated that alopecia may have substantial psychological consequences, especially in women [3]. Feelings of loss of self-confidence, low self-esteem, and heightened self-consciousness are common feelings [4]. Furthermore, people with alopecia are more likely to have depression and anxiety [4,5]. ...
... Feelings of loss of self-confidence, low self-esteem, and heightened self-consciousness are common feelings [4]. Furthermore, people with alopecia are more likely to have depression and anxiety [4,5]. Generic questionnaires may not detect all patients with QoL disorders, so for some specific diseases, a specific questionnaire may provide a more appropriate assessment, as happens in hidradenitis suppurativa, alopecia areata, or androgenetic alopecia (AGA) [6][7][8]. ...
Quality of life (QoL) can be affected in patients with alopecia. The few studies that evaluate QoL in FFA use unspecific questionnaires. The aim of this report was to design and validate a specific questionnaire to assess the impairment of QoL in FFA patients. A specific questionnaire, called the Frontal Fibrosing Alopecia Quality of Life Index (FFA-QLI), was designed and validated using the Dermatology Life Quality Index (DLQI). One-hundred and one women with FFA were included. Cronbach’s alpha value was 0.865, and the intraclass correlation coefficient between all the items in the questionnaire was 0.870. The FFA-QLI correlated positively with the DLQI (r = 0.729, p < 0.001). Patients with severe FFA showed a higher FFA-QLI (19.72) score compared to those with a mild disease (14.11) (p = 0.002), and the area under the curve for identifying severe disease was greater in the FFA-QLI than in the DLQI. The cut-off points were used to select patients with mild, moderate, and severe impairment in QoL. A score < 21 in the FFA-QLI corresponded to a low impact on QoL; values > 35 matched with greater QoL impairment; and values ranging from 21 to 35 corresponded to moderate QoL alteration. To conclude, a validated disease-specific questionnaire to assess QoL in FFA patients is here presented, with a greater power to discriminate severe cases of FFA than the DLQI.
... 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). ...
... 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.
... The mean DLQI score confirms significant disability when compared with the mean DLQI score of normal controls (0.5), reported in a previous study. 22 Overall results showed that quality of life of younger group to be less affected compared to older subjects (p< 0.05). The study provides valuable insight into psychological and aspects related to AGA. ...
... Various benefits of Nanocosmetics in Nail care[69] ...
Nanotechnology demonstrates progress in research and development by enhancing the efficiency of the product by providing innovative solutions. To overcome certain disadvantages associated with traditional products, the application of nanotechnology in cosmeceuticals has escalated. Cosmeceuticals are considered to be the fastest-growing sector in the personal care industry, and over the years they have increased dramatically. Nano-cosmeceuticals are widely used in the treatment of skin, hair, nail, and lip, in conditions such as wrinkles, photography, hyperpigmentation, pimples and hair injuries. The use of conventional supply systems has been replaced by new nanocarriers such as liposomes, niosomes, nanoemulsions, microemulsions, solid lipid nanoparticles, lipid nanostructures, and nanospheres. These new nanocarriers have increased skin penetration, controlled and sustained drug release, increased stability, specific targeting at the site, and increased trapping efficiency. Nevertheless, nanotoxicological studies have shown concern about the effects of increased use of nanoparticles in cosmeceuticals, as nanoparticles may penetrate the skin and cause health risks. This review of nanotechnology used in cosmeceutical products highlights the various new transport companies that are used to supply cosmeceutical products, their positive and negative aspects, marketable formulations, nanocosmeceutical toxicity and regulations.
... 18 Worse QoL was more common in younger patients [19][20][21][22][23][24] and in women except in children where boys and older age of onset predicted poor QOL. 25 For both men and women, AA features associated with poor QoL included more severe and widespread involvement, longer lasting and recurrent disease, as well as hair loss affecting the eyebrows and eyelashes. [19][20][21][22][23][24] Of note, beyond self-image and stigmatization, the loss of eyebrows/eyelashes was associated with ocular irritation/functional impairment whereas scalp hair loss with cold/heat sensitivity and increased risk of sunburns amplifying the effect on the QoL. ...
Alopecia areata (AA) is a common inflammatory autoimmune disease of the hair which can have a significant negative impact on the quality of life (QoL), mental health, and productivity. The aim of this scoping review is to elucidate the burden of AA focusing on these three realms. Inclusion criteria included all original manuscripts with no restriction on study type or statistical method written in English (or having an English abstract). For QoL 40 articles were included, 85 for psychiatric comorbidities, and 9 for work/school absenteeism/presenteeism mostly consisting of cross-sectional and observational cohort studies. QoL impairment was detected in over 75% of patients and up to one-third reported extremely severe QoL impairments. Specific QoL dimensions with the greatest impact were embarrassment, social functioning, as well as shopping and/or housework. Cross-sectional studies assessing the psychological burden of adult patients with AA found that the presence of signs of anxiety and/or depression ranged from 30-68% and affected all age groups. Rates of work absenteeism and unemployment were significantly higher in AA patients compared to healthy controls. Up to 62% reported making major life decisions including relationships, education and career based on their AA. Additionally, the extensive camouflage techniques and time lost from work led to a strong financial burden for patients and the numerous physician visits added to the healthcare costs. The overall impact of AA stretches much further than simply being an aesthetic concern and can negatively impact every part of an individual's life. An individualized approach and effective treatments will help reduce the psychosocial consequences and distress and return patients to their normal state of health.
... Androgenetic alopecia not only affects beauty but also results in lower self-esteem, sadness, depression, stress and impaired quality of life. 6,7 These problems are more pronounced in younger patients with more advanced alopecia. ...
Background
Androgenetic alopecia is a common, chronic, non-scarring alopecia. It is characterised by stepwise miniaturisation of the hair follicles, due to alteration in the hair cycle dynamics, leading to the transformation of terminal hair follicles into a vellus ones. Oral finasteride and topical minoxidil are the only approved drugs for treating this condition. Due to a limited number of effective therapies for androgenetic alopecia, platelet-rich plasma may be an effective alternative treatment.
Aims
To study the effect of activator in platelet-rich plasma and baseline platelet count in platelet-rich plasma on the treatment of androgenetic alopecia.
Methods
A randomised, double-blind split-head comparative study. The sample size was calculated and randomisation was done. Patients with androgenetic alopecia were allocated into two groups; in the first group, autologous activated platelet-rich plasma was injected in the right half of the affected scalp and autologous non-activated platelet-rich plasma was injected in the left half of the affected scalp and vice versa in the second group. Patients were also categorised on the basis of platelet counts in their platelet-rich plasma in three groups; group A (6-8 lakh/mm ³ ), group B (8.1-10 lakh/mm ³ ) and group C (>10 lakh/mm ³ ). Interventions were done monthly for three months and followed up for the next three months. Effects of interventions were assessed by hair density, hair thickness, patient self-assessment and clinical photography.
Results
A total of 80 patients were included in the study. Activated platelet-rich plasma produced significant improvement of hair density after four months and hair thickness at 6 months. An increase in platelet count led to a significant increase in hair density and hair thickness after three and four months respectively and a highly significant increase in both parameters at the end of the study.
Limitations
Long-term follow-up of cases was not done and no measurement of vellus hair count was done.
Conclusion
There is a significant effect of activator and platelet count of the platelet-rich plasma on hair density as well as hair thickness.
... The correlations show that visible disfigurement including scarring, hair loss, sunburn, and other facial disfigurements due to radio-chemotherapy among NPC patients can lead to low self-esteem, loss of self-confidence, regret of treatment, and shame and stigma. These result in negative psychological impacts such as depression, anxiety, and social avoidance [30][31][32][33]. We acknowledge several limitations. ...
Objective
This study examined the reliability and validity of a Shame and Stigma Scale (SSS) and assessed shame and stigma among patients with facial disfigurement from nasopharyngeal carcinoma (NPC).
Methods
Data were collected from 218 patients with NPC through a cross-sectional survey between January 14, 2020, and December 1, 2020. The original SSS is a 20-item scale with four dimensions (i.e., shame with appearance, sense of stigma, regret, and social/speech concern). We used Cronbach’s alpha and McDonald’s omega to assess reliability and exploratory factor analysis (EFA) to assess the factor structure. We also used Pearson correlation analysis to examine the relationship between each item and total score of scale items and convergent validity.
Results
The final 18-item SSS had a Cronbach’s alpha coefficient of .89. The EFA revealed that the SSS has a four-factor structure: sense of stigma, social/speech concern, shame with appearance, and regret. These factors showed satisfactory reliability, with McDonald’s omega coefficients of .87, .77, .86, and .79, respectively. The scale showed significant relationship between each item and total score of scale items with respect to item–total correlations, item–subscale correlations, and item–other-subscale correlations. Convergent validity was supported by the significant positively correlated with the total scores for depression and anxiety.
Conclusion
The SSS is valid and reliable in assessing shame and stigma and monitoring treatment compliance among patients with NPC.
... Hair loss or alopecia is a common condition that poses a psychological, social, and economic burden, thereby hindering the quality of life [5]. Therefore, several studies are being conducted to treat and prevent hair loss, including the development of drugs and cosmetics [6][7][8][9]. ...
We aimed to establish screening and efficacy test techniques for use in the development of hair-promoting agents. To this end, we used the dermal papilla cell (DPc)-derived immortalized cell line (SV40T-hTERT DPc) and neonatal foreskin-derived keratinocyte cell line (Ker-CT) to form an immortalized cell-based hair follicle-like structure. The SV40T-hTERT DPc spheroids exhibited a higher cell ratio in the spheroids than primary DPc spheroids, and SV40T-hTERT DPc aggregated with spheroids larger in diameter than primary DPc when the same cell number was seeded into the low-adhesion plate. Microscopic imaging and fluorescence staining results indicated that both primary and immortalized cell combinations form a hair follicle-like structure with a long-stretched keratinocyte layer under the condition that the spheroids have the same diameter as that of in vivo dermal papillary tissue in the hair follicle. The hair follicle-like structure elongation was increased upon treatment with three known hair follicle growth-promoting compounds (minoxidil, tofacitinib, and ascorbic acid) compared with that in the control group. Therefore, using immortalized cells to generate a coherent follicle-like structure, we have developed models for screening and evaluating hair-care materials commonly used in the industry.
... In addition to pruritus and photosensitivity, alopecia negatively impacted not only HRQoL but all three subscales of well-being. In a study assessing the effect of hair loss on quality of life, the feelings of loss of self-confidence, low self-esteem, and heightened self-consciousness in people with alopecia were identified [22]. The DLQI scores in patients with hair loss were comparable to those suffered from psoriasis. ...
PurposeEpidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are frequently associated with dermatologic adverse events (dAEs), having great impacts on patients’ health-related quality of life (HRQoL) and treatment adherence. We aimed to examine the association between various dAEs and HRQoL in patients treated with EGFR-TKI therapy.Methods
This was a cross-sectional study including 132 non-small-cell lung cancer (NSCLC) patients treated with gefitinib, erlotinib, afatinib, or osimertinib in Taiwan. The severity level of dAEs was graded by NCI-CTCAE v4.03 and PRO-CTCAE ITEMS v1.0. All participants answered the Functional Assessment of Cancer Therapy-Epidermal Growth Factor Receptor Inhibitors (FACT-EGFRI-18) HRQoL questionnaire.ResultsThe clinician-reported severity of pruritus, photosensitivity, alopecia, and Karnofsky performance status was associated with HRQoL (β = − 6.773, p = 0.046; β = − 5.250, p = 0.032; β = − 8.121, p = 0.001; β = 0.327, p = 0.002; respectively). The clinician-reported severity of all dAEs except paronychia had negative correlations with HRQoL. The symptom gradings of CTCAE and PRO-CTCAE had positive correlation.Conclusions
The severity of pruritus, photosensitivity, and alopecia was associated with HRQoL of patients receiving EGFR-TKI therapy. Using patient-reported outcome measurements helps clinicians to capture the actual impact of symptoms on physical, social-emotional, and functional well-being.
... 25,32 Although not life-threatening, treating hair loss is important, as it can have detrimental psychosocial e ects resulting in symptoms of depression 33 and diminished quality of life among both sexes. 7,[34][35][36] While women appear to be a ected more due to societal expectations, 37,38 psychological stress can be more signi cant in younger men as well. 39 Regardless of etiology, hair loss can have a signi cant negative impact on self-esteem 40 and represent a substantial nancial burden on individuals seeking treatment. ...
Objective:
The goal of this study was to assess the perceived efficacy of a standardized nutraceutical to improve hair growth and quality in men and women of various ethnicities with self-perceived hair thinning.
Methods:
This prospective, single-blind study enrolled healthy men aged 20 to 55 years (n=47) and premenopausal women aged 20 to 45 years (n=51) with self-perceived, mild-to-moderate hair thinning and included African American, Asian, Hispanic Caucasian and Non-Hispanic Caucasian participants. The nutraceutical supplement (Nutrafol® Men or Women Capsules, Nutraceutical Wellness Inc., New York, New York) was taken daily for six months. Subjects were evaluated in the clinic at baseline and Weeks 12 and 24 with two self-assessments at Weeks 4 and 8. Study endpoints were standardized digital imaging and investigator rated assessments. Self-assessment questionnaires rated hair growth, hair satisfaction, and lifestyle factors.
Results:
Investigator ratings for baseline hair growth, coverage, density, and volume were significant at Weeks 12 and 24 for all subjects (for each, p<0.001). These significant improvements were seen in 83.7 percent of men and 79.5 percent of women at Week 24. Results were similar across ethnic subgroups with significant benefit at Weeks 12 and 24 (for each, p<0.05). All subjects reported significant improvements in baseline hair appearance/quality, volume/fullness, scalp coverage, thickness, and shedding at Weeks 4, 8, 12 and 24 (for each, p<0.01).
Conclusion:
A standardized nutraceutical supplement improved visible hair growth with less notable shedding based on subjects' and investigators' overall perception of treatment benefit for men and women of various ethnic backgrounds.
... and ***p<0.001. 10 Original Research | Volume 4 | Issue 1 | ...
Background Telogen effluvium (TE) and its acute form (aTE) are two of the commonest occurrences in a trichology clinic, with patients claiming excessive hair shedding. ATE can occur in people of any age and ethnicity and is considered to be a quite common condition in either sex even if women are more likely to have a lowered quality of life and restricted social contacts as compared to men as a result of hair loss. Brittle nail syndrome (BNS) is a common condition affecting up to 20% of the population, especially women over 50 years of age. Nails affected by BNS appear ragged, thin, and dull. The clinical features of BNS include horizontal splits within the nail plate (onychoschizia) and increased longitudinal ridging or splitting (onychorrhexis). In BNS oral supplementation, trace elements and amino acids (especially L-Cystine) have been reported to be useful to ameliorate the nail plate condition. Objective We hypothesized that a nutritional approach, with nutrients of which the composition is close to the human keratin, could be effective to decrease hair loss during telogen effluvium and to improve brittle nails condition. At this purpose, a clinical study was designed to investigate the efficacy of a natural keratin hydrolysate obtained from a non-human source (feathers) on both aTE and BNS. Methods The in vivo effects of a natural keratin hydrolysate, Kera-Diet® (KD) upon human hair and nails condition was tested in a randomized, double-blind, parallel-group, benchmark (BE) and placebo (PL) controlled study involving 60 women during 90 days. In all subjects, Anagen/Telogen hair, hair volume and density, pull test, global photography, hair and nails brightness, and nail plate growth were measured at baseline and after 45 and 90 days of products use. A self-assessment test was carried out at the end of the study. Results With the KD treatment group, hair density, percentage of hair in anagen phase, hair and nails brightness, and nails growth were significantly increased compared to PL treatment group. Interestingly, with this same group, the diagnosis of aTE by pull testing was negative from 45 days. The efficacy of KD was equal to or greater than PL treatment group. Conclusion In this study, we demonstrated that daily oral administration of 1000 mg during 3 months of a natural extensively keratin hydrolysate, Kera-Diet®, associated to trace elements and specific vitamins was effective to improve both hair and nails condition. Furthermore, it demonstrates the role of nutrients in both aTE and BNS.
... [4][5][6] Delays in treatment may result in progressive and permanent alopecia as well as longterm psychosocial distress. 2,7 Scalp dermoscopy, or trichoscopy, is increasingly utilized to assist in the diagnosis of hair and scalp disorders. It has been shown to improve diagnostic accuracy and available studies in the skin of colour highlight the presence of unique features of the scalp in Black patients compared with other populations. ...
Alopecia is one of the most common reasons for a dermatology visit among Black patients. Patients with concomitant afro‐textured hair and scarring alopecias are often subjected to delays in diagnosis and treatment. Race‐discordant physicians may find the examination of scarring alopecias in ethnic hair to be daunting. Herein we present a standardized approach to evaluating the hair and scalp in afro‐textured alopecia patients in the hopes of providing a framework and guide for the proper clinical assessment of these patients. This guide focuses on common scarring alopecias specific to this ethnic population including traction alopecia, central centrifugal alopecia, frontal fibrosing alopecia and lichen planopilaris.
... As one of the most common skin diseases, hair loss has negative effects on patient's psychological well-being and reduces their life quality (Williamson et al., 2001). Previous studies indicate that psychoemotional stress plays a pivotal role in triggering and aggravating hair loss, such as alopecia areata (AA), telogen effluvium and androgenetic alopecia (Hadshiew et al., 2004;Peters et al., 2006;Alexopoulos and Chrousos, 2016;Dainichi and Kabashima, 2017). ...
Psychological stress plays an important role in hair loss, but the underlying mechanisms are not well-understood, and the effective therapies available to regrow hair are rare. In this study, we established a chronic restraint stress (CRS)-induced hair growth inhibition mouse model and performed a comprehensive analysis of metabolomics and transcriptomics. Metabolomics data analysis showed that the primary and secondary metabolic pathways, such as carbohydrate metabolism, amino acid metabolism, and lipid metabolism were significantly altered in skin tissue of CRS group. Transcriptomics analysis also showed significant changes of genes expression profiles involved in regulation of metabolic processes including arachidonic acid metabolism, glutathione metabolism, glycolysis gluconeogenesis, nicotinate and nicotinamide metabolism, purine metabolism, retinol metabolism and cholesterol metabolism. Furthermore, RNA-Seq analyses also found that numerous genes associated with metabolism were significantly changed, such as Hk-1, in CRS-induced hair growth inhibition. Overall, our study supplied new insights into the hair growth inhibition induced by CRS from the perspective of integrated metabolomics and transcriptomics analyses.
... 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 fall has been described in almost all the Ayurvedic literature as Khalitya 1 . It has been included in Shiroroga by Acharya Charaka & Ashtanga hridayakar. ...
Hair shedding is part of a natural balance, where some hairs fall out while others grow in. When the balance between hair production and shedding is interrupted that is what we called, hair loss. It can be the result of heredity, hormonal changes, medical conditions or a normal part of ageing. Anyone can lose hair on their head, but it's more common in men. when we talk about Baldness, it typically refers to excessive hair loss from your scalp. Hereditary hair loss with age is the most common cause of baldness. As far as Ayurveda is considered, it is described there by the name of Khalitya Roga under the heading of Kshudra Roga or Shiro Roga. whensoever we talk about it, it is a completely progressing disorder which is found mostly in all those persons who are indulged in sedentary ways of life, stress- induced hectic schedules along with indiscriminate dietary habits which in turn can result in any disturbance in the body which in turn can directly reflect in the form of hair loss. In this article, we will see how We can reduce & manage this rising problem of hair fall through Bhringraj capsule and oil along with Nasya. For this study, 31 patients with diffuse hair loss were instructed to gently massage the Bhringraj Taila daily onto the entire area of the scalp. Response to the therapy was evaluated at the end of four weeks. Evaluation of efficacy was done on the basis of improvement in clinical symptoms like hair fall, dandruff, itching, dryness etc. The present study thus showed a significant reduction in hair fall, dandruff, itching etc. (p < 0.001). There were no adverse reactions, either reported or observed during the entire study period and overall compliance to the treatment was excellent. Finally at last, it was concluded that Bhringraj Taila was found to be effective in alleviating Khalitya along with a significant effect on associated Keywords: Khalitya, indralopa, hair oil, Nasya, Bhringraj
... [5][6][7] Subjects with AGA have reported elevated levels of body image distress and social self-consciousness, loss of self-esteem, decreased feelings of well-being and impaired QoL. [8][9][10] Furthermore, AGA is associated with psychological disorders and symptoms like anxiety, somatisation and depression. 5 6 11 12 In addition, impaired sexual function has been documented in subjects with AGA. 10 13 Psychological features are particularly related to severe hair loss and younger age of onset. ...
Objectives
To study the association between androgenetic alopecia (AGA) and its severity with psychosocial well-being in male subjects aged 46 years at the population level.
Design
Cross-sectional study.
Setting
The Northern Finland Birth Cohort 1966 (NFBC1966).
Participants
Data were available for 892 male subjects aged 46 years.
Interventions
Study subjects underwent comprehensive health examinations including a skin evaluation by dermatologists and determination of AGA according to the Norwood classification. They also filled in a questionnaire battery that included previously validated questionnaires: the Hopkins Symptom Checklist-25, the Beck Depression Inventory–II; the Generalised Anxiety Disorder Screener; a 15-dimensional measure of health-related quality of life; a 12-Item General Health Questionnaire. The battery also included questions about self-esteem and sexual health.
Main outcome measurements
The presence of AGA and its severity, psychosocial well-being.
Results
AGA was found in 68.5% of subjects, 27.8% of the cases were severe, 33.2% moderate and 39.0% mild. There was no significant association between the presence of AGA or its severity with depression, anxiety, quality of life, self-esteem or sexual symptoms. Those with severe AGA reported lower sexual activity when compared with those without AGA; however, the difference was not statistically significant.
Conclusions
Middle-aged men with AGA did not differ from men without AGA in terms of psychosocial well-being.
... Typical symptoms of hyperandrogenization are hirsutism and acne [3]. According to epidemiological data, hirsutism affects 5-15% and acne affects 6-55% of the female population [4][5]. Oral contraceptives inhibit LH secretion, reduce testosterone levels and cause SHBG growth, thus reducing the symptoms of hyperandrogenization [6][7][8][9]. ...
Hormonal contraception in reproductive age is used not only as a birth control method but also for other indications like acne vulgaris and hirsutism. Acne vulgaris and hirsutism are important signs related to hyperandrogenaemia and provide a serious medical problem for the patients. Reduction of numerous existing symptoms leads to an improvement in the quality of women’s life. The aim of the study is to present author’s statistical data and to compare it to available data on non-contraceptive benefits.
... 18 Furthermore, fatigue is considered a health risk factor because it correlates with depression symptoms in patients, which in turn can affect their healthrelated QOL. 17 Besides, low self-confidence or self-esteem are strongly associated with patients' QOL. 19 Race, genes, age, gender, and some unhealthy lifestyle or habits are also important factors associated with the QOL of patients with degenerative lumbar diseases. [20][21][22] Although the current body of evidence suggests an association between patients' QOL and certain genetic or environmental factors, limited studies have focused on the relationship between ODLs' health-related perceptions and their QOL. ...
Purpose:
This study aimed to elucidate the quality of life of older adults/patients with degenerative lumbar diseases (ODLs) and analyse its association with some of their health-related perceptions.
Materials and methods:
This mixed-methods study consisted of a questionnaire survey and an in-depth interview, which was designed within this study. ODLs were recruited from January 12, 2017 to June 27, 2018. The independent sample t-test and grounded theory coding method were employed for data analysis.
Results:
Of the 125 participants who returned valid questionnaires, 18 were included in the in-depth interviews. ODLs' quality of life was associated with the following health-related perceptions: "life barriers", "subjective health status", and "treatment outcomes" across the domains of physiology, psychology, social relations, and environment.
Conclusion:
Our findings indicate that ODLs' quality of life is associated with their health-related perceptions. Thus, to improve older adults' quality of life, more attention should be paid to enhancing non-medical factors such as their health-related perceptions.
... Hair is regarded as one of the most important parts of the human body. It also plays a crucial role in providing insulation to the body, a sense of beauty, and self-confidence in the individuals (1,2). Despite multiple drug therapies, many individuals still suffer from hair loss or slow hair growth (3). ...
Background: Hair loss is an emotional and stressful condition with an unpredictable profound impact on the social interactions of patients. Objectives: This study aimed to evaluate the effect of grape sap on apoptosis in hair follicles. Methods: This experimental study was performed on 126 male Wistar rats within a weight range of 30 ± 250 g. The rats were assigned into seven groups, namely bleomycin group, normal saline group, grape sap group (1 mg/kg), grape sap group (10 mg/kg), grape sap group (100 mg/kg), minoxidil group, and minoxidil plus grape sap group (100 mg/kg). The rats received bleomycin (1.7 mL/kg, four times with the interval of 5 days) and then were treated with grape sap for 21 days. The skin samples were taken from rats on days 7, 14, and 21 (i.e., the last day of the treatment). Results: The results showed a significant increase in the groups treated with grape sap, compared to the bleomycin-treated group in terms of the number of follicles, sebaceous glands, and blood vessels at the base of every follicle, hair growth length, total antioxidant capacity, and BCL2 gene expression. The use of grape sap showed beneficial effects on the reduction of hair fall. Conclusions: According to the results, it seems that grape sap can be employed as a non-chemical drug due to its rich compounds, especially antioxidants, and decreases apoptosis in hair follicle cells through increasing the expression ratio of BCL2/BAX, thereby stimulating hair growth.
... Cicatricial alopecia can be categorized into primary and secondary cicatricial alopecia. In primary cicatricial alopecia, the hair follicle itself is the main target of the disease or its related adventitial dermis with relative sparing of the interfollicular reticular dermis, while in the secondary type, pathological alteration begins from nonfollicular dermis, which eventually damages the hair follicle's stem cell-based capacity for repeated regeneration [4,5]. The main causes of primary cicatricial alopecia are lichen planopilaris, discoid lupus erythematosus, pseudoplade of Brocq, and folliculitis decalvans, whereas trauma, burns, carcinoma, sarcoidosis, and infection are considered as the main causes of secondary cicatricial alopecia [6,7]. ...
Introduction: Cicatricial alopecias are a group of disorders characterized by hair follicle destruction with the consequence of permanent hair loss. The current study was conducted to evaluate the epidemiological and clinicopathological characteristics of cicatricial alopecia in Libyan community. Methods: Thirty-one patients with confirmed diagnosis of cicatricial alopecia by biopsy and tricoscopy during Jan 2018 to Dec 2019 were included in this study. Data were collected by filling a pre-designed questionnaire by all included patients. Descriptive statistics were used for analyzing the results. Chi-squared test was performed to test the relationship between different variables using SPSS 22. Results: Out of 31 cases, 16.1% of patients suffered from lichen planopilaris (LPP), 25.8% discoid lupus erythematosus (DLE), 6% Folliculitis decalvans, 6.45% pseudopelade of brocq, and 16.12% Frontal fibrosing alopecia. Conclusions: Cicatricial alopecia was found to affect mainly middle-aged individuals, particularly females. Early diagnosis and treatment can decrease the burden of this concern.
... This disease remains most prevalent in postmenopausal women (average age of 62.5 years) although cases in men and young women are also observed [1]. The hair loss in FFA is typically gradual and may spontaneously remit, but it has a notorious progressive nature and irreversible damage, leading to significant psychosocial burden, decreased quality of life, self-esteem, and increased depression and anxiety [3]. Disease stability requires prompt treatment with topical and intralesional corticosteroids, DOI: 10.1159/000518156 as well as systemic medications such as antimalarials, anti-inflammatory antibiotics, or retinoids [4]. ...
Introduction:
The prevalence of frontal fibrosing alopecia (FFA) is increasing worldwide, though the pathogenesis remains unknown. Anecdotal reports describe alopecia occurring in an FFA pattern following facial surgical procedures, but this potential link remains unexplored.
Objective:
The objective of this study is to determine if a significant association exists between the diagnosis of FFA and a history of facial and scalp surgical procedures.
Methods:
This retrospective study comparing data from frontal alopecia patients to controls was conducted at a tertiary medical center. Additionally, a literature review was conducted on scarring alopecias occurring from scalp procedures.
Results:
Fifty percent of frontal alopecia patients (n = 54) reported a history of facial surgical procedures compared to 9.8% of controls (n = 51) (OR: 7.8 [95% CI: 2.77-25.98, p < 0.001]). Although no significant differences were observed in current daily facial sunscreen use, sunscreen use prior to alopecia onset was significantly higher in frontal alopecia (p = 0.295; p = 0.021). Sunscreen use was not a significant modifier in the association between frontal alopecia and facial surgical procedures (p = 0.89).
Conclusions:
A significant association exists between frontal alopecia clinically consistent with FFA and a history of facial surgery, the nature of which is unclear. The role of sunscreen use and frontal alopecia development in this setting needs to be better elucidated.
... Excluding genetic pattern hair loss, diffuse loss begins as early as age 30 [1]. While the net loss of hair does not affect an individual's medical health, it does have negative effects on confidence and quality of life [2,3]. Thus, it is an important problem to address. ...
Objective
Increasing hair fullness is a global unmet need for many men and women. An approach to the problem is to decrease hair fall or shedding by reducing scalp stratum corneum oxidation and barrier damage to increase hair retention. This study evaluated a combination of functional antioxidants and barrier-enhancing cosmetic ingredients to improve scalp condition thereby enabling stronger hair anchorage and longer retention.
Methods
Male and female subjects with normal scalp condition and self-perceived hair thinning participated in a 24-week, double-blind, placebo-controlled, randomized clinical study assessing either a regimen of treatment shampoo and leave-on treatment containing functional antioxidant and barrier-enhancing agents or an identical placebo chassis shampoo control. The functional ingredients were piroctone olamine, zinc pyrithione, zinc carbonate, niacinamide, panthenol, and caffeine. At baseline and after 8, 16, and 24 weeks of product use, several measurements were taken: hair shedding, total hair count (by phototrichogram), hair samples, TEWL, and evaluation of biomarkers of scalp and hair conditions. Subjects also completed self-assessment questionnaires.
Results
Statistically significant effects for functional ingredient-containing treatment regimen versus a placebo control shampoo formulation were observed for reduced hair shedding, increased total hair count, reduced TEWL, and improvement in scalp biomarker values. Subjects also noticed these improvements assessed via self-assessment questionnaires.
Conclusions
These results establish that use of functional antioxidant and barrier-enhancing agents to further improve scalp condition can enable a reduction in hair shedding and thus an increase in perceived hair fullness. The underlying improvements in scalp condition suggest the hair benefits were achieved as a result of improved scalp skin barrier and scalp condition leading to a viable preventative approach for hair thinning.
... Hair is a part of the body with a bold cosmetic aspect that affects people's life. 1 Some studies have shown the association of alopecia with psychological disorders such as depression and anxiety; therefore, physicians should consider this condition more than a cosmetic disorder. 2,3 Different types of alopecia are categorized into two groups, including nonscaring and scaring alopecia. ...
Ant‐induced alopecia is a rare condition caused by Pheidole pallidula species. This particular cause of nonscaring alopecia should be considered a new differential diagnosis. Ant‐induced alopecia is a rare condition caused by Pheidole pallidula species. This particular cause of nonscaring alopecia should be considered a new differential diagnosis.
... However, DLQI scores of these 2 groups were decreased to almost the same point after 6 months of vismodegib therapy. Thanks to common and worldwide usage of the DLQI questionnaire, it is relatively easy to make an assessment comparing not only with other skin tumours, but also with other dermatological conditions, such as hidradenitis suppurativa (27), atopic dermatitis (28), chronic urticaria (28), alopecia (29), acne (30), psoriasis (31), Hailey-Hailey disease or Darier's disease (32) (Fig. 2). QoL of patients with BCC seems to be less affected than in the above-mentioned dermatoses, and is similar to other skin tumours (33). ...
The incidence of basal cell carcinoma has increased in recent years. The aim of this study was to analyse the influence of itch on quality of life and psychosocial status of patients with basal cell carcinoma. A total of 180 patients with basal cell carcinoma were included in the study. Itch intensity was assessed with Numerical Rating Scale and 4-Item Itch Questionnaire (4IIQ). Quality of life in basal cell carcinoma was assessed with the 36-item Short-Form Health Survey (SF-36), Dermatology Life Quality Index (DLQI), 6 Item Stigmatization Scale (6-ISS) and Beck Depression Inventory (BDI). Mean DLQI in the study group was 2.0 ± 2.0, while mean SF-36 was 71.38 ± 15.77 points. The intensity of itch assessed with 4IIQ correlated negatively with SF-36 (R = -0.48, p = 0.003). The mean ± SD BDI score was 6.16 ± 5.72 points and mean 6-ISS score was 0.66 ± 1.24. In conclusion, presence and intensity of itch may debilitate quality of life among patients with basal cell carcinoma.
... 1 Often, the clinical severity does not reliably predict the quality of life in patients with alopecia; therefore, prompt diagnosis is essential when managing any type of hair loss. 2 Bitemporal hair loss is a common nding in clinical practice and demands thorough evaluation. Accurate diagnosis requires detailed medical history, grooming practices, physical examination, dermatoscopic evaluation, and sometimes histopathologic evaluation. ...
BACKGROUND: Bitemporal hair loss can be a diagnostic challenge because several entities may affect this region of the scalp, including both scarring and nonscarring conditions. Although traction alopecia is the most common cause of bitemporal hair loss, no studies to date have outlined all of the potential causes. OBJECTIVE: We sought to review nonscarring and scarring conditions that have a clinical presentation of bitemporal hair loss, including traction alopecia, telogen effluvium, female pattern hair loss, frontal fibrosing alopecia, central centrifugal cicatricial alopecia, and seborrheic dermatitis. METHODS: A Google Scholar and PubMed literature search were conducted for this review. The keywords used in the search included the following: "traction alopecia", "telogen effluvium", "androgenic alopecia", "androgenetic alopecia", "female pattern hair loss", "alopecia areata", "frontal fibrosing alopecia", "central centrifugal cicatricial alopecia", and "seborrheic dermatitis". The scope of our search included all research articles published from 1957 to February 2019. In total, 94 articles regarding non-scarring and scarring hair loss were selected and included according to topic relevance. Exclusion criteria included articles that did not address the epidemiology and/or clinicopathologic or dermatoscopic findings of non-scarring and scarring forms of alopecia. Inclusion criteria included articles that addressed a clinical presentation of bitemporal hair loss; or addressed epidemiology, clinical presentation, dermatoscopic findings, and/or treatment. RESULTS: Bitemporal hair loss is a common and often distressing condition with a broad differential. CONCLUSION: Clinicians must be aware of the potential causes of bitemporal hair loss. Prompt diagnosis is essential to prevent further hair loss, especially in scarring conditions.
... The most severe effect on patients with hair loss was in the form of social embarrassment at leisure, work or study, whereas the least effect was noted in sports and relationships [13]. In addition, the study by Williamson et al. [14] on 70 patients with alopecia reported a mean DLQI score of 8.3 ± 5.6. ...
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.
Understanding heuristics in stage financing is imperative, given the consequences of staging for both new venture entrepreneurs and VC investors. This study documents how entrepreneurs’ physical attractiveness affects VCs’ staging intensity during the early stages of the funding process, while taking into account the ethnic constellation of a given VC – entrepreneur dyad. Using a dataset for a representative sample of 231 European IT-ventures, the study finds that physical attractiveness of the lead entrepreneur and the ethnic constellation of a given VC-entrepreneur dyad independently and jointly affect a VC’s staging intensity during the early stages of the financing process. These findings were subjected to a two-stage least squares analysis and Heckman selection models.
Background: Alopecia areata (AA) is among the most common immunological conditions. Although AA is considered to be a medically benign condition, those living with AA often report comorbid psychiatric conditions, high levels of functional impairment, and diminished quality of life. These consequences are largely due to the unique psychological turmoil associated with the condition. Unfortunately, little research has considered how to improve quality of life outcomes for this group. Aims: The purpose of this study was to evaluate how the PERMA framework of well-being is associated with the individual subjective experience of AA. A greater understanding of how PERMA applies to this group holds promise for assisting clinicians with devising psychosocial coping strategies for this population. Method: 274 individuals were recruited for participation. Hierarchical regression analyses were used to evaluate associations between the PERMA variables and AA-related (a) subjective symptoms (e.g., self-consciousness, sadness) and (b) relationship impact (e.g., perceived attractiveness). Each analysis controlled for demographic and condition-specific variables. Results: Demographic and PERMA variables were found to be significantly associated with positive experiences of each quality of life outcome. Limitations: The male to female ratio of participants was biased toward females. Furthermore, the nature of cross-sectional survey research has inherent limitations. Conclusion: The findings provide support for a relationship between PERMA variables and quality of life outcomes among people with AA. Clinical implications and future research directions are discussed.
Objectives:
Hair loss, including alopecia, is a common dermatological issue worldwide. At present, the application of fractional carbon dioxide (CO2 ) laser in the treatment of alopecia has been documented; however, the results vary between reports. These varying results may be due to the limited knowledge of cellular action in laser-irradiated skin. The objective of this study was to investigate the molecular and cellular mechanisms of laser treatment under effective conditions for hair cycle initiation.
Methods:
A fractional CO2 laser was applied and optimized to initiate the hair cycle in a mouse model of alopecia. Several cellular markers were analyzed in the irradiated skin using immunofluorescence staining. Cellular populations and their comprehensive gene expression were analyzed using single-cell RNA sequencing and bioinformatics.
Results:
The effective irradiation condition for initiating the hair cycle was found to be 15 mJ energy/spot, which generates approximately 500 μm depth columns, but does not penetrate the dermis, only reaching approximately 1 spot/mm2 . The proportion of macrophage clusters significantly increased upon irradiation, whereas the proportion of fibroblast clusters decreased. The macrophages strongly expressed C-C chemokine receptor type 2 (Ccr2), which is known to be a key signal for injury-induced hair growth.
Conclusions:
We found that fractional CO2 laser irradiation recruited Ccr2 positive macrophages, and induced hair regrowth in a mouse alopecia model. These findings may contribute to the development of stable and effective fractional laser irradiation conditions for human alopecia treatment.
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Wigs provide a common service as hair accessories in people's daily life. However, the traditional wigs, regardless of the matrices derived from human hair or synthetic fibers, are faced with limitations such as short service life, dry and brittle texture, and static electricity. In this work, we described a new strategy for surface coating of wigs via the Langmuir-Blodgett (LB) technique using a nanocomposite composed of hair-derived keratin and graphene oxide (Ker/GO). In contrast to the conventionally used immersion method, this strategy achieved a significantly higher surface coverage with a close-packed structure and controlled deposition layers of the coating, thus delivering high performances, including greatly enhanced ultraviolet (UV) resistance, antistatic electricity, heat dissipation, hydroscopicity, and moisturizing ability, and durability against washing, for both the human hair and synthetic-fiber-based wigs.
Background:
Lagerstroemia indica (L. indica) is reported to have diverse biological activities including anti-inflammatory, anti-cancer, neuro-regulatory, antidiabetic and antioxidant activity.
Aims:
The purpose of the present study is to examine the potential of hair growth promotion and/or hair loss prevention by L. indica extract.
Patients/methods:
The effects of L. indica on hair growth have been studied in human hair follicle dermal papillary (hHFDP) cells and follicular organ culture ex vivo by cell proliferation assay, PCR, western blot analysis and reporter gene activity assay. Moreover, a clinical trial was conducted in healthy volunteers.
Results:
L. indica significantly promoted the proliferation of hHFDP cells, which was associated with increased expression of TCF/LEF, VEGF and Gli1 mRNA, and inhibition of STAT6 and Smad2 mRNA. Treatment with L. indica also increased the TCF/LEF reporter gene activity but downregulated the SBE- and STAT6-luciferase activities. The expression of total β-catenin, CDK4 and CDK2 were elevated, while that of STAT6 and SMAD2/3 was suppressed upon treatment with L. indica. In human hair follicles organ culture, L. indica significantly inhibited hair follicular degeneration. The clinical trial showed a statistically significant rise in total hair count in test group (n=24) after 24 weeks of applying the hair tonic enriched with L. indica (141.46 ± 21.27 number/cm2 , p < 0.05).
Conclusion:
We suggest that L. indica extract prevents hair loss as well as stimulate hair growth by regulating the Wnt-β-catenin, JAK3-STAT6 and TGF-β1-Smad signaling pathways, and may be further developed as a novel functional cosmetic for preventing hair loss.
A full head of hair is an essential part of the general body image ideal, it has always been regarded as a symbol of virility and strength and is closely related to physical attractiveness. In contrast, baldness has always been associated with unfavorable meanings and negative feelings.
Background
Alopecia areata (AA) is an inflammatory disorder, marked by chronic, persistent, and patchy loss of hair. At present intralesional/topical corticosteroids, Minoxidil solution, and topical immune-therapies are used for treatment. Though all these have side effects and high rate of relapse. As QR678 Neo® is proved to be effective in hair regrowth in male and female pattern hair loss, the aim of the study is to compare the efficacy of QR678 Neo® with intralesional steroid therapy vs. intralesional steroid alone in the treatment of AA of scalp in men and women.
Materials and methods
A total of 20 participants in age group of 20–50 years with nonscarring patchy hair loss were chosen for the study. Patients were arbitrarily divided into two groups (Group A—intralesional steroid with placebo and Group B-intralesional steroid with QR678 Neo®). All the participants were evaluated at baseline, 3 months and 6 months with standard global photography, dermoscopic assessment, and self-evaluation questionnaire at the end of study.
Result
Marked improvement was seen in the global assessment score after 6 months (mean- 6.6 SALT) as compared to baseline (38.5 SALT score) in group B. There was significant reduction of black dots, yellow dots, broken hairs, and tapered hair at 6 months on video dermoscopic examination in group B. Also, higher satisfaction was experienced with the treatment in group B patients.
Conclusion
QR678 Neo® in combination with intralesional steroids therapy proved to be significantly beneficial, efficient, and can be considered as safer treatment option for alopecia areata.
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.