Article

Effects of Tocotrienol Supplementation on Hair Growth in Human Volunteers

Authors:
  • School of Pharmaceutical Sciences, University of Science Malaysia, Glugor, Penang
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Abstract

Studies have shown an association between oxidative stress and alopecia. Patients with alopecia generally exhibit lower levels of antioxidants in their scalp area as well as a higher lipid peroxidation index. Tocotrienols belong to the vitamin E family and are known to be potent antioxidants. Hence, a study was conducted to investigate the effect of tocotrienol supplementation on hair growth in volunteers suffering from hair loss. Twenty one volunteers were randomly assigned to orally receive 100 mg of mixed tocotrienols daily while 17 volunteers were assigned to receive placebo capsule orally. The volunteers were monitored for the number of hairs in a pre-determined scalp area as well as the weight of 20 strands of 1 cm length hair clippings at 0 (before supplementation), 4 and 8 months. The number of hairs of the volunteers in the tocotrienol supplementation group increased significantly as compared to the placebo group, with the former recording a 34.5% increase at the end of the 8-month supplementation as compared to a 0.1% decrease for the latter. Nevertheless, the cumulative weight of 20 strands of hair clippings did not differ much from the baseline for both supplementation groups at the end of the study period. In conclusion, this trial demonstrated that supplementation with tocotrienol capsules increases hair number in volunteers suffering from hair loss as compared to the placebo group. This observed effect was most likely to be due to the antioxidant activity of tocotrienols that helped to reduce lipid peroxidation and oxidative stress in the scalp, which are reported to be associated with alopecia.

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... In particular, a few single components have been reported to be able to promote hair growth with effects on gene regulation. Some previous studies have examined the hair growth-promoting effects of tocopherol acetate, L-menthol, and stevioside [2][3][4]. ...
... Tocopherol has been reported to possess high antioxidant potency. The effect of orally administered tocotrienol (a tocopherol derivative) on hair growth has been investigated in volunteers with alopecia [2], showing that volunteers in the tocotrienol supplementation group had significant increases in the numbers of hairs than those in a placebo group, most likely due to the antioxidant activity of tocotrienols that can reduce oxidative stress in the scalp [2]. However, the effects of tocopherol administered by topical application on hair growth in animal models or humans through clinical evaluation have not been reported yet. ...
... Tocopherol has been reported to possess high antioxidant potency. The effect of orally administered tocotrienol (a tocopherol derivative) on hair growth has been investigated in volunteers with alopecia [2], showing that volunteers in the tocotrienol supplementation group had significant increases in the numbers of hairs than those in a placebo group, most likely due to the antioxidant activity of tocotrienols that can reduce oxidative stress in the scalp [2]. However, the effects of tocopherol administered by topical application on hair growth in animal models or humans through clinical evaluation have not been reported yet. ...
Article
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Oral finasteride and topical minoxidil are single components approved by the US FDA for treating hair loss. Some other compounds originating from natural products are also traditionally used for promoting hair growth. In this study, observations of treated keratinocyte cells were used to demonstrate that tocopherol acetate, L-menthol, and stevioside exert an effect on cell regeneration. Furthermore, these were topically applied to the shaved skin of C57BL/6 mice to observe their effects on hair growth. A mixture of tocopherol acetate, L-menthol, and stevioside showed the highest potential for promoting hair growth in vivo. In in vivo experiments, the mixture of tocopherol acetate, L-menthol, and stevioside was more effective than tocopherol acetate or L-menthol alone in promoting hair growth. The transcriptome analysis of skin from the dorsal side of a mouse treated with tocopherol acetate or L-menthol versus vehicle revealed key changes in keratin, keratin-associated protein, forkhead box, sonic hedgehog, fibroblast growth factor 10, desmoglein 4, deoxyribonuclease 1-like 2, and cadherin 3, known to play roles in promoting hair growth.
... 족하여 이에 대한 연구가 필요한 실정이다. 산화스트레스 (Oxidative stress)는 원형탈모(Alopecia Areata)를 일으키는 하나 의 원인으로 연구되고 있으며 치약의 성분 중 항산화 효과를 보이는 tocopherol을 이용하여 원형탈모에 대한 임상시험을 진 행한 결과 tocotrienol(토코트라이에놀)을 공급한 지원자군이 placebo약물을 공급한 지원자 군과 비교하여 유의미한 모발 성 장을 나타나낸 것으로 보고되었다 [2]. 이는 두피의 산화스트레 스가 tocotrienol에 의한 항산화 활성에 의해 감소되었기 때문일 것으로 제시되었다 [2]. ...
... 산화스트레스 (Oxidative stress)는 원형탈모(Alopecia Areata)를 일으키는 하나 의 원인으로 연구되고 있으며 치약의 성분 중 항산화 효과를 보이는 tocopherol을 이용하여 원형탈모에 대한 임상시험을 진 행한 결과 tocotrienol(토코트라이에놀)을 공급한 지원자군이 placebo약물을 공급한 지원자 군과 비교하여 유의미한 모발 성 장을 나타나낸 것으로 보고되었다 [2]. 이는 두피의 산화스트레 스가 tocotrienol에 의한 항산화 활성에 의해 감소되었기 때문일 것으로 제시되었다 [2]. 그러나 tocopherol을 국소적으로 바르는 방법으로 적용한 동물 모델 실험이나 임상적으로 평가한 실험 에 대해서는 아직까지 보고된 바가 없다. ...
... In this hypothetical, hyperglycaemic blood circulates to the scalp where it feeds the respiratory chain process and contributes to unabated oxidative damage of dermal papilla cells. It is therefore no surprise that potent antioxidants have been promoted in the context of hair rejuvenation (Beoy, Woei, & Hay, 2010). ...
... Shin et al., 2013). Hence, treatment options for androgenetic alopecia should be complemented with topical penetrative (pharmacokinetically viable) antioxidants, such as vitamin E succinate (Beoy et al., 2010), and antimicrobial agents against P. acnes and Malassezia spp. Dietary modifications should aim to lower animal fat intake and focus on low glycaemic index foods, fortified with magnesium. ...
Article
Background The success of 5α-reductase inhibitors in the 1990s vindicated the role of androgens and cast doubt on the role of diet in androgenetic alopecia (AGA). However, poor glucose control and high cholesterol are now recognised as comorbidities, which are salient characters of the ‘western diet’. Scope and approach In glucose potentiated hair loss, continuous monosaccharide flux to the liver promotes the polyol pathway, causing fatty liver and attenuating synthesis of sex hormone binding globulin, accommodating the increased ratio of dihydrotestosterone (DHT) to testosterone. The scalp of the balding phenotype is characterised by overactive PPAR-γ receptors, increased fatty acid synthesis, enlarged sebaceous glands and sebum secretions. Sebum feeds lipophilic bacteria, such as Propionibacterium acnes, which augment the expression of prostaglandin-type (PGD2 & 15d-PGJ2) ligands of PPAR-γ and increase local insulin sensitivity via Akt/mTOR pathways. In hyperglycaemic events the androgen dependent polyol pathway depletes glucose and generates purine by-products that antagonise adenosine receptors. Mitochondrial reactive oxygen species accumulate, and ATP levels reduce, slowing gluconeogenesis in the outer root sheath keratinocytes of the hair follicle. Furthermore, the current commentary suggests that an important mineral in hair health is magnesium, which is relevant to both glucose and cholesterol potentiated hair loss. Magnesium deficiency not only reinforces insulin resistance, but in cholesterol potentiated hair loss, local magnesium dependent monooxygenase enzymes that metabolise cholesterol and vitamin D are impaired. Furthermore, magnesium deficient muscles at the occipital and temporal region of the skull create mechanical strain against the galea aponeurotica. Key findings and conclusions Taking all of this into consideration, treatment options for androgenetic alopecia should include a low cholesterol and low glycaemic index diet, improved glucose control, and fortification with magnesium. Furthermore, the current narrative does not endorse severe caloric restriction for obvious health reasons.
... 15 During studies testing the effect of tocotrienol on peripheral neuropathy, we were struck by an unexpected observation that murine skin topically treated with tocotrienol showed more robust hair growth. Although there is anecdotal evidence reported in the literature claiming improvement of hair growth in humans by tocotrienol, 16 the underlying mechanisms remain elusive. Thus, the objective of the present study was to unveil the mechanism of tocotrienol-induced hair folliculogenesis in the adult skin. ...
... [50][51][52] Consistent with the finding of our work, Beoy et al. reported induction of hair growth by TRF in humans. 16 TRF represents a rich, natural source of tocotrienol that is readily accessible and generally recognized as safe by the Food and Drug Administration (FDA; GRN no. 307). ...
... Triglycerides esters of oleic acid and palmitic acid and other fatty acids, such as squalene (up to 0.7%) and sterols (about 0.2% phytosterol and tocopherol) [35] Coconut (Cocos nucifera) Saponin [36] Celery (Apium graveolens) ...
... Olive oil acts as hair moisturizer hair and skin irritation reducer. In addition, vitamin E in olive oil protects a hair loss [35]. Thus, olive oil is good to be used in cosmetic hair preparations such as gel and liquid hairtonic. ...
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Nowadays, Herbal cosmetic is growing rapidly as most women prefer natural products rather than chemicals products for their personal care. Herbal cosmetic contains natural nutrients to improve and provide consumers satisfaction due to relatively fewer side effects compared to synthetic cosmetics. Indonesia is one of the biggest supplier’s countries for herbal raw materials in cosmetic products. Many plants are available naturally as well as different uses that can be made as basic ingredients for cosmetic preparations, such as onion dayak bulb, kemuning leaf, pegagan, kecombrang, red betel, pecan, and sweet root. This review aimed to provide information on plants in Indonesia based on the phytochemicals contents that can be formulated into various categories of cosmetic preparations, such as skin care, hair care, anti-aging, skin whitening, and antioxidant.
... 15 During studies testing the effect of tocotrienol on peripheral neuropathy, we were struck by an unexpected observation that murine skin topically treated with tocotrienol showed more robust hair growth. Although there is anecdotal evidence reported in the literature claiming improvement of hair growth in humans by tocotrienol, 16 the underlying mechanisms remain elusive. Thus, the objective of the present study was to unveil the mechanism of tocotrienol-induced hair folliculogenesis in the adult skin. ...
... [50][51][52] Consistent with the finding of our work, Beoy et al. reported induction of hair growth by TRF in humans. 16 TRF represents a rich, natural source of tocotrienol that is readily accessible and generally recognized as safe by the Food and Drug Administration (FDA; GRN no. 307). ...
Article
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Unlike the epidermis, which regenerates continually, hair follicles anchored in the subcutis periodically regenerate by spontaneous repetitive cycles of growth (anagen), degeneration (catagen) and rest (telogen). The loss of hair follicles in response to injuries or pathologies such as alopecia endangers certain inherent functions of the skin. Thus, it is of interest to understand mechanisms underlying follicular regeneration in adults. In this work, a phytochemical rich in the natural vitamin E tocotrienol (TRF) served as a productive tool to unveil a novel epidermal pathway of hair follicular regeneration. Topical TRF application markedly induced epidermal hair follicle development akin to that during fetal skin development. This was observed in the skin of healthy as well as diabetic mice which are known to be resistant to anagen hair cycling. TRF suppressed epidermal E-cadherin followed by 4-fold induction of β-catenin and its nuclear translocation. Nuclear β-catenin interacted with Tcf3. Such sequestration of Tcf3 from its otherwise known function to repress pluripotent factors induced the plasticity factors Oct4, Sox9, Klf4, c-Myc and Nanog. Pharmacological inhibition of β-catenin arrested anagen hair cycling by TRF. This work reports epidermal E-cadherin/β-catenin as a novel pathway capable of inducing developmental folliculogenesis in the adult skin.
... Se ha demostrado, en ensayos con ratas, que el efecto antioxidante del a-tocotrienol puede ser hasta 40- 60 veces, más potente que el del a-tocoferol 20 y esta habilidad se ha atribuido a su mayor facilidad, a distribuirse entre las capas lipídicas de la membrana celular, lo que le permite una mejor interacción con los radicales libres. En el caso de la alopecia, Beoy y col 21 demostraron en un ensayo aleatorizado, que la suplementación con cápsulas de tocotrienol aumentó significativamente el número de cabellos, en pacientes con alopecia (n=21) respecto del grupo placebo (n=17), lo que se atribuyó a la actividad antioxidante de los tocotrienoles, que ayudó a reducir la peroxidación lipídica y el estrés oxidativo en el cuero cabelludo 21 . ...
... El cabello desempeña una importante función en el ser humano 21 . Además de amortiguar y proteger el cuero cabelludo de la luz solar directa, presenta una significación sociológica en términos de sexo, edad, valores o status y ayuda al individuo a proyectar una imagen positiva 22 . ...
... There are however very limited data about the effect of vitamin E supplementation. Only one study [245] has shown that a mixture of tocotrienols taken every day for 4-8 weeks was able to increase the hair number in AA patients. By contrast, another study has reported the adverse effects on hair growth in volunteers taking every day excessive vitamin E (270 mg or 600 IU) during only 28 days [246]. ...
Article
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The relationship between oxidative stress and skin aging/disorders is well established. Many topical and oral antioxidants (vitamins C and E, carotenoids, polyphenols) have been proposed to protect the skin against the deleterious effect induced by increased reactive oxygen species production, particularly in the context of sun exposure. In this review, we focused on the combination of vitamin E and selenium taken in supplements since both molecules act in synergy either by non-enzymatic and enzymatic pathways to eliminate skin lipids peroxides, which are strongly implicated in skin and hair disorders.
... [8] Tocotrienol and alpha-tocopherol lead to 34% better hair counts through inhibition of lipid peroxidation and reduction in ROS. [19] Protein energy malnutrition and single nutrient deficiencies are known to compromise immunity. There have been detail studies on nutritional programming of the immune system. ...
Article
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Genetic, androgenic, epigenetic, environmental, lifestyle, diet, and nutritional factors have influence over promoting or regulating inflammation, immunity, and genetic expression predisposing to hair loss. Oxidative stress is a major mediator for various mechanisms of hair loss, including the release of transforming growth factor-β ( TGF-β). Nutrients counter oxidative stress, repair cellular damage, support cellular functions, and restore hair growth. Nutrients can be synergistic or antagonistic. Covert subclinical nutritional deficiencies are common. Higher dose of nutrients does not mean higher efficiency but may reverse the benefits converting an antioxidant to become prooxidant. Nutrients do not work alone but are supported by accessory micronutrients which ensure biological utilization. Providing proper nutritional environment can neutralize free radicals and perpetuate active hair growth cycles.
... Androgen receptor inhibitors, such as flutamide, bicalutamide, fluridil, cyproterone acetate and spironolactone, work with β-catenin to suppress Wnt signaling, thereby stimulating HFSC proliferation and differentiation and leading to hair follicle regeneration and partial hair regrowth [127][128][129][130]. Tocotrienol is a member of the vitamin E family. Topical tocotrienol-rich fraction application markedly induced anagen hair growth by upregulating the expression and nuclear translocation of β-catenin 4-fold [131,132]. Inducing and maintaining the anagen phase of the hair cycle is the basis of treating alopecia. Recent studies revealed that 3,4,5-tri-O-caffeoylquinic acid, ginkgolide B and bilobalide, morroniside and Polygonum multiflorum extract could promote hair follicle cycling or accelerate the onset of anagen and delay hair follicle catagen via the activation of the Wnt/β-catenin signaling pathway in HFSCs [18,133,134]. ...
Article
Full-text available
Hair follicle stem cells (HFSCs) reside in the bulge region of the outer root sheath of the hair follicle. They are considered slow-cycling cells that are endowed with multilineage differentiation potential and superior proliferative capacity. The normal morphology and periodic growth of HFSCs play a significant role in normal skin functions, wound repair and skin regeneration. The HFSCs involved in these pathophysiological processes are regulated by a series of cell signal transduction pathways, such as lymphoid enhancer factor/T-cell factor, Wnt/β-catenin, transforming growth factor-β/bone morphogenetic protein, Notch and Hedgehog. The mechanisms of the interactions among these signaling pathways and their regulatory effects on HFSCs have been previously studied, but many mechanisms are still unclear. This article reviews the regulation of hair follicles, HFSCs and related signaling pathways, with the aims of summarizing previous research results, revealing the regulatory mechanisms of HFSC proliferation and differentiation and providing important references and new ideas for treating clinical diseases.
... Eight months of supplementation with 50 mg of mixed tocotrienols and 23 IU of α-tocopherol resulted in 34.5% increased hair count in 38 patients with hair loss, compared to a 0.1% decrease with placebo. The ability of the derivatives to inhibit lipid peroxidation may limit hair follicle oxidative stress, thus preventing hair loss; however, additional studies are needed (Beoy et al.,2010). Lysine is an essential amino acid found in meat and eggs, and is thought to play a role in the absorption of iron. ...
... Beoy et al demonstrated their ability to increase hair growth, due to the ability to inhibit lipid peroxidation and reduce hair follicle oxidative stress. 29 Biotin Biotin, also known as vitamin B7, is one of the most popular nutrients in many over-the-counter hair growth supplements, mainly due to its function in keratin production. However, despite its substantial advertising in this field, in patients suffering from hair loss, it is still controversial if oral biotin supplements do offer benefits, irrespective of serum https://doi.org/10.2147/CCID.S359052 ...
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Post-COVID-19 telogen effluvium has been largely reported as a sequela in the post-acute phase of COVID-19, causing major emotional distress among the affected patients. The affected individuals are further exposed to a vast amount of misinformation from the internet and social media and it is important for physicians to be familiar with the phenomenon and provide appropriate counselling to their patients regarding this condition. This article aims to review the evidence-based complementary strategies that can help enhance hair regrowth after post-COVID-19 hair loss, from psychological support and patient education to the importance of optimal nutrition and potential indications and benefits of oral nutritional supplementation, as well as the role of both topical and injectable hair growth stimulators.
... 19 The authors concluded that the e ect was most likely due to antioxidant activity, inhibition of lipid peroxidation, and oxidative stress in the scalp. 5,18,19 In addition to the components detailed above, Nutrafol contains amino acids, marine collagen, hyaluronic acid, organic kelp, and vitamins and minerals that have been identi ed to play a role in the stress response as well as gut, thyroid and hair health. 5 There are currently four formulations available: Nutrafol Women, Nutrafol Women's Balance, Nutrafol Postpartum, and Nutrafol Men, which has a higher concentration of saw palmetto. ...
Article
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Background: Several oral nutraceuticals have recently emerged as products marketed to increase hair growth and thickness. However, these supplements typically lack the rigorous testing and statistically significant data that apply to pharmaceuticals. Therefore, the potential benefits of oral nutraceuticals for conditions of hair loss, such as androgenetic alopecia, have yet to be fully understood by dermatologists. Objective: The purpose of this article is to evaluate current studies in the literature to assess the efficacy of popular oral nutraceuticals marketed for hair growth in subjects with androgenetic alopecia. Methods: This article reviews the currently available literature on the nutraceuticals Nutrafol® and Viviscal® for hair growth and describes and evaluates the results observed. Results: Oral nutraceuticals are effective to a modest degree in promoting hair growth in men and women with androgenetic alopecia. Conclusion: Oral nutraceuticals have demonstrated efficacy in promoting modest hair growth in men and women with androgenetic alopecia and may serve as useful adjuncts to current treatments. As the popularity of nutraceuticals grows, it is important for dermatologists to be knowledgeable of the potential benefits and pitfalls of these supplements to appropriately counsel patients seeking treatment for hair loss.
... During the follow-up at year 1, the patient also reported observing less hair loss and a higher rate of hair growth. This is consistent with a previous study that showed tocotrienols supplementation increased hair growth 34.5% between the baseline and the end of the 8-month study [30] . Oxidative stress in the scalp was reported to be associated with hair loss [31] . ...
Article
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A female patient in her 40’s of mixed Chinese-Indian ancestry was referred to our neurology clinic for frequent migraine with aura and CADASIL. She had been treated for acute encephalopathy in 2014. The incident led to her CADASIL diagnosis and later retinitis pigmentosa, both rare conditions. Initial clinical assessment showed moderate severity of migraine and normal cognitive function. As there is no specific treatment recommended for CADASIL, the patient was maintained on pharmacological therapies for secondary prevention of ischaemic stroke, treatment of seizure, symptomatic treatment for migraine and a cholesterol-lowering drug. A supplement containing Vitamin E (tocotrienols) was recommended. During the ensuing 5-years, there were no further neurovascular incidents and her migraine went into full remission.
... In an 8-month treatment of 38 patients with hair loss, increased hair counts in 34.5% [90]; thought to be due to inhibition of lipid peroxidation and reduction in oxidative stress in the hair follicle. ...
Article
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Nutraceuticals, natural dietary and botanical supplements offering health benefits, provide a basis for complementary and alternative medicine (CAM). Use of CAM by healthy individuals and patients with medical conditions is rapidly increasing. For the majority of breast cancer patients, treatment plans involve 5–10 yrs of endocrine therapy, but hair loss/thinning is a common side effect. Many women consider this significant, severely impacting on quality of life, even leading to non-compliance of therapy. Therefore, nutraceuticals that stimulate/maintain hair growth can be proposed. Although nutraceuticals are often available without prescription and taken at the discretion of patients, physicians can be reluctant to recommend them, even as adjuvants, since potential interactions with endocrine therapy have not been fully elucidated. It is, therefore, important to understand the modus operandi of ingredients to be confident that their use will not interfere/interact with therapy. The aim is to improve clinical/healthcare outcomes by combining specific nutraceuticals with conventional care whilst avoiding detrimental interactions. This review presents the current understanding of nutraceuticals beneficial to hair wellness and outcomes concerning efficacy/safety in breast cancer patients. We will focus on describing endocrine therapy and the role of estrogens in cancer and hair growth before evaluating the effects of natural ingredients on breast cancer and hair growth.
... In this regard, there is an increasing interest in nonhormonal factors that play a role in AGA pathogenesis and their relationship with hormonal status [6]. In particular, micronutrients (trace elements, vitamins, and essential amino acids), a number of which have shown a positive effect on the growth and strengthening of hair roots capture the attention of researchers [7][8][9][10][11]. The regular use of food supplements, a topical L-carnitine tartrate, zinc, niacin, branched chain amino acids, and biotin treatment, led to a decrease in the rate of hair loss and an increase in the anagen/telogen ratio in individuals with AGA [12]. ...
Article
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Androgenetic alopecia (AGA) is the most common variant of male pattern baldness in which occurrence and development of multiple genetic, hormonal, and metabolic factors are involved. We aimed to estimate plasma element content (Mg, Ca, Zn, Cu, Se, Fe), vitamin status (B12, D, E, and folic acid) in patients with AGA using direct colorimetric tests or atomic absorption spectrometry, and the influence of these parameters in the formation of various hair loss patterns. The study included 50 patients with I–IV stages of AGA divided into two groups with normal and high levels of dihydrotestosterone compared with 25 healthy individuals. The presence of two patterns of pathological hair loss in the androgen-dependent (parietal) and androgen-independent (occipital) areas of the scalp was confirmed. It was shown that all patients with AGA have a deficiency of elements (Zn, Cu, Mg, Se) and vitamins (B12, E, D, folic acid). However, the hair loss rate was not due to their content. А positive interrelation between quantitative trichogram parameters in the occipital region and iron metabolism in pairs “hair density vs Fe” and “hair diameter vs ferritin” was shown. In turn, in the parietal region, an inverse correlation of hair diameter with plasma Cu level was found, the most pronouncing in patients with high levels of dihydrotestosterone. The obtained results indicate the importance of multiple micronutrient deficiencies in the AGA occurrence accompanied by the existence of two different hair loss patterns, differently related to the content of certain trace elements and androgens in the blood.
... The positive experience of topical minoxidil therapy, a piperidino-pyrimidine derivative (2,4-diamino-6-piperidino-pyrimidine-3-oxide) [16] that is an ATP-sensitive potassium channel agonist (K(ATP)) channels), is known [17]. Partial restoration of hair growth is indicated after the systematic use of trace elements [18,19], vitamins [20], and their combinations [15,21,22]. At the same time, the substantial price and labor costs for such treatment are not always justified, which determines the relevance of the search for early informative predictors of the effectiveness of conservative therapy. ...
Article
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Androgenic alopecia (AGA) is the most common type of progressive hair loss in man. The search for reliable predictors of the conservative treatment's effectiveness is an urgent problem today. Forty-eight patients with AGA, stages I-IV by the Norwood-Hamilton scale, were treated for 4 months with 5% topical minoxidil joints with corrections for trace element and vitamin imbalances. In most cases, the positive therapy's effect was shown in the parietal but not in the occipital area, whereas that effect was observed in others. The attempts to associate the therapy's effectiveness with initially defined genetic, hormonal, and metabolic parameters showed the absence of differences between groups with positive and negative outcomes. Among the studied nutrient parameters (Zn, Cu, Mg, Ca, Fe, and Se, as well as vitamins B12, E, D, and folic acid), differences between these groups was shown in zinc content only. The starting point from a zinc plasma level above 10 µmol/L likely provides the success of the subsequent conservative therapy and correlates with an increase in the hair density and diameter in the parietal area. The integral predictive value of the Zn plasma level was assessed as 72.3% (positive predictive value: −88%; and negative predictive value: −55%).
... 50 Aoi et al documented direct hair inductive capacity of Vitamin D3 on the dermal papilla, 51 while Beoy et al demonstrated that tocotrienol and alpha tocopherol supplements improved hair counts by inhibition of lipid peroxidation. 52 From these various scientific works, we can conclude that the use of antioxidants and nutrients have a role in the management of hair loss. ...
Article
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Abstract: Patients are losing faith in our hair loss management due to fear of side effects. Researchers today agree that it is not raised DHT, but the altered tissue response of the follicles at the tissue level, which is responsible for hair loss (1,2). The altered response is in the form of disturbance of metabolism, disturbance of ATP formation, energy utilization, accumulation of free radicals, reactive oxygen species (ROS), reactive nitrogen species (RNS), peroxides and other free radicals, creating inflammation, compromising immunity, making the follicle weak and vulnerable. The hair loss occurring today is not hormonal. Hair loss can occur without raised androgens and without family history, it can skip siblings and skip generations (3,4). Therefore it is not called androgenetic alopecia anymore. It is referred to as male pattern hair loss (MPHL) and female pattern hair loss (FPHL). Should we still insist on treating it like androgenetic alopecia? The male hormone was in focus in the beginning, when it was thought that only men go bald and hair loss runs in families. We were trying to search and treat a cause. But hair loss is not a sickness or a disease, it is more of a disturbance or slowing down of the biological cycles due to unfavourable conditions at the cellular level. Baldness progresses gradually over a few years. Only the weak hair are lost in a pattern or in a diffuse manner. Rising exposure to pollution, stress, UV rays, sleep cycles, fast foods, poor nutrition, depleting nutrition in the soil, chemicals and EDCs through food and water, altered climatic and season patterns, smoking, alcohol, lifestyle, lack of exercise are making the hair roots weak. The hair loss seen presently is not hormonal, it does not respond to anti androgens alone. We can strengthen the follicles, provide nutrition for energy, repair, restoration, control hair loss and achieve hair growth, as concluded through data from this controlled clinical trial. There is another dimension to hair loss which needs to be explored and deciphered. Data from clinical trial: A controlled clinical trial for hair loss management, using antioxidants, iron, calcium, aminoacids, B-complex, biotin, in men and women without the use of anti androgens or DHT blocker, finasteride, showed an average improvement in density of 18% at 2 months and 30% and at 4 months. Hair loss was controlled within 4-6 weeks (6). The average improvement in calibre in 2 months was 9% and at 4 months was 21% (6,7). The improvement was seen in all the patients, there were no non responders to this regimen, as are reported in finasteride and minoxidil studies (8,9). The approach has also helped in hair loss due to smoking (10), hair loss due to pollution (11), hair shaft disorders like monilethrix caused due to poor hair structure too have benefited from nutritional support (12). It has also helped a unusual case of hair loss from exposure to cell phone radiation (13), apart from being consistently effective in management of routine hair loss. Two study groups and two control groups of 100 men, 100 women of similar age and grades of hair loss were compared with a one year follow up. Tattooed areas of hair loss were marked and analyzed by folliscope counts of density and caliber in addition to global photography and personal patient evaluation scores.
...  Vitamin E is a potent antioxidant and one of the study showed significant results on hair gain by giving tocotrienol supplementation (a vitamin E compound) (39)  Vitamin H or Biotin deficiency is rare due to its adequate production by intestinal bacteria. But some studies showed its role on hair loss, one of the studies is on infant nourished formula, in which, the child does not have the sufficient biotin in diet, reported with patchy hair loss and it resolved with daily biotin supplementation (Fujimoto , Inouki, Fukui, Inoue, & Kuhara,2015). ...
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With increased industrialization and urbanization, although a lot of progress has been achieved in the medical field leading to the increase in life expectancy. But simultaneously there has been an emergence of health and cosmetic related issues. Almost every individual is suffering from one or the other problem due to change in their lifestyle, dietary habits, stress, and other environmental factors such as pollution. Hair fall, among various health and dermatology problems is most common cosmetic concern experienced by everyone at any point of their life with prevalence of 50% by the age of 35years which increases with advancing age in men and in women to 40% by the age of 50 years. Though it is not life threatening or debilitating condition but it has huge social and psychological impact as it is concerned with one’s appearance. In Unani System of Medicine, hair fall is classified as Intithār al-Sha‘r (Telogen Effluvium) and a number of local and oral drugs have been mentioned in classical Unani literature for the management of hair fall, but before starting pharmacotherapy Unani scholars recommend balance moderation in Asbab –e sitta zaruriyah (Six essential pre-requisite for maintaining health), to cut down dependency over pharmacotherapy. In this paper, we have discussed the prevention of Intithār al-Sha‘r (Telogen Effluvium) by alteration in Asbab-e- Sitta Zaruriyah. Key words: Hair fall, Asbabe Sitta Zaruriyah, Telogen Effluvium
... Vitamin D should therefore form an integral part of all hair growth treatments. Beoy, Woei and Hay reported 34% improvement in hair counts due to effective inhibition of lipid peroxidation and reduction of oxidative stress from the combined use of tocotrienol and alpha tocopherol [64]. Kwack and Shin reported hair growth and hair elongation by ascorbic acid derivative mediated release of Insulin like Growth Factor, IGF 1 [65]. ...
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Abstract: Our quest for establishing a cause and effect relationship has lead us to accept that only androgens and DHT causes hair loss. However there are various other internal and external factors resulting in hair loss due to dysregulation of the hair growth cycles. There are non hormonal factors that influence and carry out metabolic interactions maintaining a cellular environment to ensure the intricate balance of hair growth cycles. Oxidative stress generated by ROS (Reactive Oxygen Species) from external exposure to pollution, smoking, pesticides in foods, contamination of soil, water, etc. as well as excessive ROS formation due to internal metabolic derangements, can lead to hair loss. Vitamin and mineral deficiencies have been clinically detected in hair loss patients and are known to alter the immune response. Though the prevalence of nutritional deficiencies is common these are covert deficiencies. The nutrient deficiencies cannot always be detected clinically as the deficiencies are masked and compensated by self regulating processes of redistributing the utilization of nutrients in the body, arresting hair growth during stress, sickness, exertion, recovery, etc. which we know as telogen effluvium, and by novel mechanisms like autophagy. In deficiency states body conserves the nutrients by restricting hair growth. It is worthy to note that apparent deficiency of a single nutrient has a cascading effect on optimum utilization of multiple other nutrients and functioning of other body systems. When we desire to stimulate or ensure hair growth it is logical to ensure a supply of building blocks, which are the necessary nutrients, in order to support cell division and growth. We have been investigating hair loss all the time. Let us now change our perspective and direct our efforts on how to strengthen the hair roots to withstand the onslaught of damage and enhance hair growth. In the present review, a low dose comprehensive cyclical nutrient therapy, for hair growth utilized in our practice is included. Here we propose the hypothesis and discuss the scientific basis and mechanism of how to achieve hair growth with the use of nutritional supplements.
... Eight months of supplementation with 50 mg of mixed tocotrienols and 23 IU of α-tocopherol resulted in 34.5% increased hair count in 38 patients with hair loss, compared to a 0.1% decrease with placebo. The ability of the derivatives to inhibit lipid peroxidation may limit hair follicle oxidative stress, thus preventing hair loss; however, additional studies are needed [94]. ...
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The treatment of alopecia is limited by a lack of therapies that induce and sustain disease remission. Given the negative psychosocial impact of hair loss, patients that do not see significant hair restoration with conventional therapies often turn to complementary and alternative medicine (CAM). Although there are a variety of CAM treatment options on the market for alopecia, only a few are backed by multiple randomized controlled trials. Further, these modalities are not regulated by the Food and Drug Administration and there is a lack of standardization of bioactive in gredients in over-the-counter vitamins, herbs, and supplements. In this article, we provide a comprehensive review of the efficacy, safety, and tolerability of CAM, including natural products and mind and body practices, in the treatment of hair loss. Overall, there is a need for additional studies investigating CAM for alopecia with more robust clinical design and standardized, quantitative outcomes.
... Ascorbic acid is also potent in skin elasticity enhancement and treatment of skin problems such as acne and rosacea owing to its collagen synthesis and anti-inflammatory properties, respectively (Telang 2013). In addition, Beoy et al. (2010) stressed the important of vitamin E mainly tocotrienol in case of alopecia, atype of hair loss. A group of volunteers consumed the supplement containing tocotrienol for 8 months. ...
Article
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Consumer consciousness on the concept of natural-based ingredients triggers the natural cosmetics market to grow. The active compounds in natural ingredients offer valuable bioactivities such as antioxidant, photoprotection, anti-aging and anti-inflammatory actions that useful for skincare, hair care and dental care. This review presents an overview on natural ingredient, especially plant-derived, used in cosmetic products and the examples of Malaysian plants used for cosmetic purposes. © 2018 Penerbit Universiti Kebangsaan Malaysia. All Rights Reserved.
... Difference #2: Differences with Other Sources of Astaxanthin E complex contains several different tocopherols and tocotrienols. And in fact, the tocotrienol constituents yield outstanding health benefits while the tocopherol constituents are not nearly as active (Sen et al., 2006;Beoy et al., 2010;Magosso et al., 2013;Haghhighat et al., 2014). ...
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Bob Capelli’s third book on Astaxanthin is by far his best. Well over 300 pages long, this book is the definitive guide on Astaxanthin for use as a health supplement by humans as well as animals. This book is a great tool for scientists and people working in the supplement industry, while written in an easy-to-read format to be enjoyed by anyone. It provides valuable information for any consumer seeking to live a long and healthy life. Features include: • Excerpts from many renowned doctors, researchers and opinion leaders describing Astaxanthin in their own words including Dr. Joseph Mercola, Mike Adams “The Health Ranger,” Dr. William Sears, Suzy Cohen “America’s Most Trusted Pharmacist” and more. • Extensive review of “The Healthy Ten” – the ten clinically-validated health benefits of Natural Astaxanthin. • What makes Natural Astaxanthin “The Supplement You Can Feel” – how 80% of consumers can feel it working in their bodies. • Emerging research on Astaxanthin for five new health benefits. • Why nutrition experts are beginning to call Natural Astaxanthin “The Ultimate Anti-Aging Nutrient” and “The Athlete’s Secret Weapon.” • Dosage, bioavailability, safety and other vital information. • Differences between: o Natural Astaxanthin and other supplements. o Different sources of Astaxanthin. o Production methods for Natural Astaxanthin from algae. o Different Astaxanthin consumer products. • Complete list of 330 references included. While Capelli’s first two books contained testimonials from consumers, perhaps the most interesting new feature of this book is a long chapter relating what renowned doctors and opinion leaders as well as university researchers and PhDs say about Astaxanthin. Here is what some of these famous contributors say about this book: Dr. Joseph Mercola, Renowned Internet Health Expert: “I was very impressed with the compelling research on the therapeutic benefits of Astaxanthin in Bob Capelli’s book on Astaxanthin back in 2011. I have been regularly using it since then and believe it has great value for many conditions. Bob’s book was a major factor when I decided to feature Astaxanthin as “The #1 Supplement You’ve Never Heard of that You Should Be Taking” on the Dr. Oz show a few years ago.” Mike Adams, “The Health Ranger:” “Astaxanthin is, without question, one of the most potent and promising natural medicines yet known in the realm of nutritional science. I strongly recommend reading Bob Capelli’s latest Astaxanthin book. Your approach to nutritional supplementation will be forever upgraded!” Suzy Cohen, “America’s Most Trusted Pharmacist:” “Natural Astaxanthin is one of my favorite nutrients to recommend to my readers because it does so many positive things for people. It’s a super-antioxidant and a broad-spectrum, safe & natural anti-inflammatory with over 500 medical research studies to back it up. Astaxanthin is the perfect nutrient in the battle against aging because of its clinically-validated effects on a host of concerns people have as they reach middle age and beyond. I read Bob Capelli’s first book on Astaxanthin back in 2007 and I’ve been a fan ever since. And with this new book, Bob has taken the understanding of Astaxanthin to a whole new level.” Susan Smith Jones, PhD, Prolific Author and Media Personality: “A gem of nature, Astaxanthin is an all-in-one natural nutrient that can replace countless other supplements in your kitchen because of its myriad benefits for the entire body. I refer to Astaxanthin as “The Great Protector” in my lectures and workshops. Thank you Bob Capelli for distilling down hundreds of complicated research studies into this revealing, cogent book that beautifully extols the virtues of an antioxidant extraordinaire.”
... Minimal information in the literature exists regarding benefits of vitamin E supplementation on hair loss. One study of 21 volunteers who received tocotrienol supplementation (100 mg of mixed tocotrienols daily) showed significant increase in hair number as compared to a placebo group [57]. ...
Article
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Patients presenting with hair loss should be screened by medical history, dietary history and physical exam for risk factors for nutrient deficiency. If warranted, laboratory studies may be performed. In patients with no risk factors, further laboratory evaluation searching for nutritional deficiencies is not warranted. For patients with nutritional deficiencies, it is clear that those deficiencies should be corrected. Further research is required to determine whether any benefit exists for nutrient supplementation in the absence of documented deficiency. At this time, patients must be informed that such research is lacking and that in fact some supplements carry the risk of worsening hair loss or the risk of toxicity.
... Thus making Vitamin D an important inclusion for promotion of hair growth. Beoy, Woei and Hay studied the benefit of 100 mg mixed tocotrienol and alpha tocopherol resulting into 34% improvement in hair counts attributed to potent inhibition of lipid peroxidaiton and reduction of oxidative stress [42]. Jin, Zhu and Wu compared zinc, copper, iron and manganese contents in hair in patients with male pattern alopecia and healthy men confirming low levels of nutrients in patterned hair loss [43]. ...
Article
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Multiple nutritional, environmental and lifestyle factors can directly affect hair follicles, to weaken and make them sensitive to the action of androgens. Hair loss can be corrected and hair growth can be improved by addressing these non-androgenic factors. Patients having hair fall, thinning, loss of volume and poor growth can be precursors to androgenetic alopecia. Recent research has shown that androgens inhibit hair growth through release of Transforming Growth Factor (TGF) ß1. Further study of this mechanism reveals that generation of Reactive Oxygen Species (ROS) induced by androgens leads to release of TGF ß1 and use of ROS scavengers can block the release of TGF ß1, explaining beneficial role of antioxidants in hair growth. The binding of ROS to intracellular proteins also causes hair loss by altering the protein structure, changing their immune recognition and converting them to new antigens targeted by inflammatory and immune systems. Calorie restriction and individual micronutrient deficiencies lead to a new process of intracellular destruction or autophagy before cell apoptosis, which could explain cessation of hair growth. Telogen is not a resting phase but now defined as active conservation of follicles under unfavourable conditions. Thus any stress, trauma, metabolic change or insult causes telogen. Micronutrients zinc, copper, selenium maintains immunity, control inflammation and preserve antioxidant activity of the cells. Vitamins A, C, D have a role in phagocytosis and antibodies maintaining resistance. Vitamin D3 modulates the hair-inductive capacity of dermal papilla cells. Vitamin and micronutrient deficiencies are prevalent among all the population of the world. Nutritive value of the foods has reduced over the years by 30%. Endocrine Disrupting chemicals are creating further damage to the hormonal balance of the body. All these can be countered by use of antioxidants and a well-planned nutritional program which will ensure strengthening and regrowth of hair follicles, without the use of Finasteride.
... The dose of TRF and duration of supplementation is sufficient and comparable to other studies using the same preparation for a variety of conditions [29,30]. Therefore, the lack of effectiveness over placebo is not due to these factors. ...
Article
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Background Attention Deficit/Hyperactive Disorder (ADHD) is often treated with medications but many parents seek alternative treatment for fear of adverse effects. Increased oxidative stress has been observed in children and adults with ADHD. We postulate that tocotrienol-rich fractions (TRF), a potent antioxidant from the natural Vitamin E family, may help children with ADHD. The objective of this study is to determine if supplementation of TRF has an effect on the symptoms of school-going children with ADHD. Methods Children aged between 6 to 12 years with ADHD were randomized to TRF 200 mg or placebo daily for 6 months. We measured the NICHQ Vanderbilt ADHD Parent (VAPRS) & Teacher (VATRS) Rating Scales at baseline, 3 months and 6 months. Plasma tocotrienol levels were also measured at each of the corresponding time. We used ANOVA repeated measure and Spearman Rho’s for analysis. ResultsOne hundred forty-six children were randomized. The VAPRS showed significant improvement after 3 months and 6 months in both groups (n = 73 each). The VATRS revealed greater improvement in the TRF group but was not statistically significant (p = 0.07). The TRF group had higher levels of tocotrienols compared with the placebo group at 3 and 6 months. There was a small but significant correlation of the alpha and gamma tocotrienol levels with the change in VAPRS after 6 months. ConclusionTRF was not more effective than placebo in reducing the ADHD symptoms as measured by the VAPRS and VATRS. Possible reasons for this include placebo-effects and supplementations given too late in life. Future studies should consider using an objective outcome measurement (e.g. measuring attention-span) as well as earlier age of supplementation. Trial registrationClinicalTrials.gov NCT01855984, date of registration 10 May 2013.
... 특히, 최근 항산화 효과 및 면역조절 작용 등을 나타내는 천연물을 이용하여 발모효과가 우수하면서도 부작용이 적은 발모제를 개발하기 위한 연구들이 다양하게 수 행되고 있다. Lim 등은 tocotrienol의 섭취가 두피의 지질과산 화 및 산화적 스트레스를 감소시켜 발모를 촉진하는 것으로 보고하였으며 (Lim et al., 2010), Joo는 수종의 천연물과 Lactobacillus plantarum 균주를 이용한 발효추출물의 도포가 모발생장에 관여하는 cytokine을 조절하여 C57BL/6 mouse의 모발성장을 촉진하는 것으로 보고하였다 (Joo, 2011 (Han, 2006). 찔레뿌리의 생리활성에 관한 연 구로 Choi 등은 찔레뿌리 유기용매 추출물이 HMG-CoA reductase의 활성을 억제하여 닭의 혈청 콜레스테롤을 유의하 게 낮추는 겄으로 보고하였고 (Choi et al., 1993), Lee와 Choi (1999) *Hair growth was evaluated by the scoring index: 0% (−), 0~20% (+), 20~40% (++), 40~60% (+++), 60~80% (++++) and 80~100% (+++++). ...
Article
In this study, to develop hair growth agents using natural products which has excellent ability to promote hair growth effect and fewer side effect, animal experiment and clinical trials was performed to evaluate hair growth promotion effect of herbal product containing Rosamutiflora roots extracts as a main component (RMHP). 4-week-old male C57BL/6 mice were removed the dorsal hair using thioglycolate, and applied 15% EtOH solution as a negative control, 5% minoxidil as a positive control and RMHP to dorsal skin. In the results of macroscopy and photo-interpretation, RMHP group recorded 100% (+++++) of hair growth was proved to significantly stimulate hair growth against 80% (++++) negative control group. 37 patients were treated with RMHP and evaluated the therapeutic effect at 16 weeks. Hair density was significantly increased at 16 weeks after applying RMHP (125.0?4.9\;FU/cm^2) compared to before treatment (104.3?4.7\;FU/cm^2, p mm) than before treatment (0.055?0.002 mm, p (p
... 43) More than 50 studies indicate that policosanol decreases serum cholesterol, while other studies failed to reproduce this effect, 44) and tocotrienol possess po- tent antioxidant activity. 45) Upon examining the hair growth-promoting effects of the major components in RB-SCE, LA and OZ exhibited outstanding hair growth-promoting potential, showing similar results to that of 3% minoxidil based on macroscopic and histological evaluation (Fig. 6-8). Especially, in the LA and OZ groups, the number of hair follicles was markedly increased compared to the negative control group. ...
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The potential hair growth-promoting activity of rice bran supercritical CO2 extract (RB-SCE) and major components of RB-SCE, linoleic acid, policosanol, γ-oryzanol, and γ-tocotrienol, were evaluated with the histological morphology and mRNA expression levels of cell growth factors using real-time reverse transcriptase-polymerase chain reaction (PCR) in C57BL/6 mice. RB-SCE showed hair growth-promoting potential to a similar extent as 3% minoxidil, showing that the hair follicles were induced to be in the anagen stage. The numbers of the hair follicles were significantly increased. In addition, mRNA expression levels of vascular endothelial growth factor (VEGF), insulin-like growth factor-1 (IGF-1), and keratinocyte growth factor (KGF) were also significantly increased and that of transforming growth factor-β (TGF-β) decreased in RB-SCE-treated groups. Among the major components of RB-SCE, linoleic acid and γ-oryzanol induced the formation of hair follicles according to examination of histological morphology and mRNA expression levels of cell growth factors. In conclusion, our results demonstrate that RB-SCE, particularly linoleic acid and γ-oryzanol, promotes hair growth and suggests RB-SCE can be applied as hair loss treatment.
Article
Importance Despite the widespread use of nutritional supplements and dietary interventions for treating hair loss, the safety and effectiveness of available products remain unclear. Objective To evaluate and compile the findings of all dietary and nutritional interventions for treatment of hair loss among individuals without a known baseline nutritional deficiency. Evidence Review The MEDLINE, Embase, and CINAHL databases were searched from inception through October 20, 2021, to identify articles written in English with original findings from investigations of dietary and nutritional interventions in individuals with alopecia or hair loss without a known baseline nutritional deficiency. Quality was assessed with Oxford Centre for Evidence Based Medicine criteria. Outcomes of interest were disease course, both objectively and subjectively measured. Data were evaluated from January 3 to 11, 2022. Findings The database searches yielded 6347 citations to which 11 articles from reference lists were added. Of this total, 30 articles were included: 17 randomized clinical trials (RCTs), 11 clinical studies (non-RCT), and 2 case series studies. No diet-based interventional studies met inclusion criteria. Studies of nutritional interventions with the highest-quality evidence showed the potential benefit of Viviscal, Nourkrin, Nutrafol, Lamdapil, Pantogar, capsaicin and isoflavone, omegas 3 and 6 with antioxidants, apple nutraceutical, total glucosides of paeony and compound glycyrrhizin tablets, zinc, tocotrienol, and pumpkin seed oil. Kimchi and cheonggukjang, vitamin D 3 , and Forti5 had low-quality evidence for disease course improvement. Adverse effects were rare and mild for all the therapies evaluated. Conclusions and Relevance The findings of this systematic review should be interpreted in the context of each study’s design; however, this work suggests a potential role for nutritional supplements in the treatment of hair loss. Physicians should engage in shared decision-making by covering the potential risks and benefits of these treatments with patients experiencing hair loss. Future research should focus on larger RCTs with active comparators.
Chapter
Vit E is a collective term referring a group of 8 naturally occurring lipid-soluble molecules (homologs), of which 4 are tocopherols (α, β, γ, and δ tocopherols) and 4 are tocotrienols (α, β, γ and δ tocotrienols) [1]. Vit E was discovered in 1922 by Evans and Bishop, of the University of California in Berkeley, and the name “tocopherol” they proposed is derived from the Greek word “tocos” = offspring and the Greek verb “phero” = to bear, since the unknown till that time molecule was required to prevent fetal resorption in pregnant rats fed lard-containing diets that were easily oxidizable [2]. The -ol ending indicates its alcohol functional group. Tocopherol became known as the “antisterility vitamin”, but soon scientists realized that it had this effect only in rats.
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Self-emulsifying drug delivery systems (SEDDS) have been shown to enhance the water-solubility and oral bioavailability of poorly water-soluble compound. Solid SEDDS (s-SEDDS) address the stability and compatibility issues associated with conventional liquid SEDDS, but have limitations including the use high amounts of surfactants and complex processes resulting in low final drug loading and poor powder flow. The aim of the present study was to formulate a solid dosage form containing 100 mg tocotrienols using the optimized s-SEDDS powder we developed with tocotrienol-rich fraction (TRF) as the model liquid active substance via a simple adsorption method. The s-SEDDS granules formulated via wet-granulation with PVP K30 showed excellent flow properties, retained good emulsification efficiency, with submicron emulsion droplet size and dissolution profile of 75–100%. The oral bioavailability evaluated in human subjects showed that of the s-SEDDS capsules was comparable absorption to that of the commercial liquid self-emulsifying product Tocovid Suprabio™, which demonstrated enhanced tocotrienols’ bioavailability by 3-fold compared to that of an oily non self-emulsifying preparation. In conclusion, the bioavailability of tocotrienols from the s-SEDDS was encouraging and can be a promising alternative and a convenient solid dosage form that can significantly enhance the oral bioavailability of the tocotrienols.
Article
Background: The aim of this study was to study new therapeutic options for the treatment of female and male androgenetic alopecia (AGA) and to assess the efficacy of a possible new coadjuvant oral and topical therapy, containing a complex of natural substances. Methods: Sixty individuals affected by mild-to-moderate female and male AGA were enrolled in the study and underwent the oral and topical treatment with a microemulsion formulation for 6 months. At baseline and at 3- and 6-month follow-up, global photographs were taken and three expert operators evaluated photographs using the 7-point scale. On a subgroup of our sample, non-invasive phototrichograms with TrichoScan® HD at baseline and follow-ups were performed to collect the trichological parameters of total number of hairs, hair density/cm2, vellus hair density/cm2, terminal hair density/cm2 and hair thickness. One-way ANOVA and Unpaired Student t-test were performed to analyze the data. Results: Using the 7-point scale, a clinically visible improvement of hair loss was observed after three and six months of treatment. A statistically significant increase of all TrichoScan® trichological parameters was observed at both 3- and 6 month-follow-ups. Conclusions: the complex of natural and active substances tested in this work showed good efficacy in improving both male and female hair loss. These new products could represent a valid alternative or coadjuvant therapy of AGA, increasing the efficacy of conventional treatments such as minoxidil or finasteride.
Article
Objective To review the literature on valproate-associated hair abnormalities and the available treatment options. Methods We searched PubMed and Google Scholar with keywords including “valproate”, “valproic acid”, “hair”, “alopecia”, and “effluvium,” supplemented with hand search from cross-references. We included all types of studies including case reports in this review. Results The pathophysiology of hair loss includes telogen effluvium, biotin, mineral deficiency, and possibly hyperandrogenism. Diagnosis is based on history of hair loss or abnormalities following valproate treatment, and is confirmed by use of simple clinical tests such as pull test and modified wash test. Treatment involves reassurance and advice on hair care, and if possible drug discontinuation or dose reduction. Medications such as biotin and other vitamins with minerals supplementation is effective for most individuals with hair loss. Other treatment options are agomelatine, topical valproate or minoxidil, though these lack evidence. Conclusion Hair abnormalities with valproate are common, benign adverse effects, and management includes general measures and specific treatment options.
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Hair follicle stem cells (HFSCs) are among the most widely available resources and most frequently approved model systems used for studying adult stem cells. HFSCs are particularly useful because of their self-renewal and differentiation properties. Additionally, the cyclic growth of hair follicles is driven by HFSCs. There are high expectations for the use of HFSCs as favourable systems for studying the molecular mechanisms that contribute to HFSC identification and can be applied to hair loss therapy, such as the activation or regeneration of hair follicles, and to the generation of hair using a tissue-engineering strategy. A variety of molecules are involved in the networks that critically regulate the fate of HFSCs, such as factors in hair follicle growth and development (in the Wnt pathway, Sonic hedgehog pathway, Notch pathway, and BMP pathway), and that suppress apoptotic cues (the apoptosis pathway). Here, we review the life cycle, biomarkers and functions of HFSCs, concluding with a summary of the signalling pathways involved in HFSC fate for promoting better understanding of the pathophysiological changes in the HFSC niche. Importantly, we highlight the potential mechanisms underlying the therapeutic targets involved in pathways associated with the treatment of hair loss and other disorders of skin and hair, including alopecia, skin cancer, skin inflammation, and skin wound healing.
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Oxidative stress(OS) has been implicated as one of the etiologies in the multifactorial etiopathogenesis of alopecia areata (AA). But with the existing data, it is unclear whether oxidative stress is a cause or effect of the disease state in Alopecia areata. Aim To measure the oxidative stress parameters viz .malon-di-aldehyde(MDA),superoxide dismutase (SOD) , total antioxidant status (TAS) in patients of alopecia areata and their association with the severity of alopecia areata(AA) . Patients/Methods The sample size was forty (n=40) clinically diagnosed patients of alopecia areata and forty (n=40) age and sex matched healthy controls.ELISA was used for the evaluation of MDA, and spectrophotometric method was used to evaluate serum TAS and whole blood SOD. Results Mean serum TAS levels and whole blood SOD of cases were lower than controls (p=0.005 and p= 0.002 respectively).Mean serum MDA levels of the patients suffering from alopecia areata was significantly higher compared to controls (p=0.001).Levels of serum TAS in patients of alopecia areata were found to decrease from mild to severe grades of disease; as evidenced by an increasing SALT score (p=0.003).There was an increase in levels of serum MDA from mild to severe grades of disease (p<0.001).The whole blood SOD levels were found to decrease with an increase in disease severity (p <0.001). Conclusion The OS parameters were deranged in all subsets of AA, the greatest derangement was seen in patients with whole blood SOD which was found to be lower in patients with severe disease.
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delete Edited by K O'Connor, L J Golderg Healthy hair results from a combination of good generalized health and mindful health care practices. Many nutritional deficiencies lead to poor hair health and include changes to hair structure, texture, and viability. Although the mechanisms by which individual nutrients contribute to hair growth and maintenance have yet to be fully resolved, there are a variety of risk factors that predispose an individual to a nutritional deficiency; age, malnutrition, malabsorption, and medication use are among the most common. A thorough history should be taken in a patient with a hair disturbance to identify risk factors for a nutritional deficiency, which will then guide directed laboratory testing and treatment.
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Hair loss has a multifactorial etiology that includes internal and external triggers. These include poor diet and nutrition (extrinsic), as well as the natural aging process (intrinsic). Other external factors include pollution, hair products, hair styling, and ultraviolet exposure, which can cause free radical formation, oxidative stress, and microinflammation at the site of the hair follicles. Botanic substances have demonstrated antioxidant, anti-inflammatory, and immune-enhancing properties. Vitamins and minerals are needed when deficiencies are apparent or demonstrate efficacy at higher doses than normally found in one's diet. The safety and efficacy of oral nutraceuticals have been demonstrated in clinical trials.
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Hair supplements are a vast and growing industry. Patients often turn to oral supplements to address hair concerns as they are easily accessible. There are numerous products on the market, many with thousands of reviews (both positive and negative). Nutritional supplements are regulated by the FDA as foods instead of drugs, meaning they do not have to prove their efficacy and safety before becoming available to consumers. While some oral supplements have strong evidence supporting their use for hair growth, many ingredients have not been tested in clinical trials, have only in vitro evidence for hair growth, or have only been tested in animals. Given these industry characteristics, it is important for dermatologists to be aware of the safety and utility of these ingredients to provide appropriate counseling to their patients. The goal of this review is to evaluate the efficacy of popular hair growth oral supplement ingredients and formulations. This review does not address the topical formulations of these ingredients and their effects on hair growth.
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Androgens have an intense consequence on the human scalp and body hair. Scalp hair sprouts fundamentally in awol of androgens whereas the body hair hike is vulnerable to the activity of androgens. Androgenetic alopecia (AGA) invoked as males emulate Alopecia due to the cause of the dynamic reduction of scalp hair. Androgens are medium of terminus growth of hair although the body. Local and system androgens convert the extensive terminal follicles into lesser vellus like structure. The out start of this type of alopecia is intensely irregular and the reason behind this existence of enough circulating steroidal hormones androgens and due to genetic predisposition. Effective treatments are available in the market as well as under clinical and preclinical testing. Many herbal formulations are also available but not FDA approved. Different conventional and NDDS formulations are already available in the market. To avoid various systemic side effects of both Finasteride and Minoxidil, topical formulations and natural products (nutrients, minerals, vitamins) now a days are being widely used to treat Androgenic alopecia. CAM (complementary and alternative medicine) provides the option to elect favorable, low-risk, adjuvant and alternative therapies. Herein, we offer a widespread review of topical marketed formulations, natural products, and CAM treatment options for AGA. Graphic Abstract
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Persistent hair loss is a major cause of psychological distress and compromised quality of life in millions of people worldwide. Remarkable progress has been made in understanding the molecular basis of hair loss and identifying valid intracellular targets for designing effective therapies for hair loss treatment. Whereas a variety of growth factors and signaling pathways have been implicated in hair cycling process, the activation of Wnt/β-catenin signaling plays a central role in hair follicle regeneration. Several plant-derived chemicals have been reported to promote hair growth by activating Wnt/β-catenin signaling in various in vitro and in vivo studies. This mini-review sheds light on the role of Wnt/β-catenin in promoting hair growth and the current progress in designing hair loss therapies by targeting this signaling pathway.
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Background Oxidative damage to melanocytes, resulting from an imbalance between the damaging oxidative pathways and the protective anti‐oxidants likely plays a pathogenic role in vitiligo. Aim To evaluate three parameters related to the oxidative stress (OS) pathway namely malon‐di‐aldehyde (MDA), a marker of oxidative damage, and superoxide dismutase (SOD) and reduced glutathione (rGSH) (both antioxidants)in patients with active and stable vitiligo with either localized or generalized disease. Patients/Methods Sixty clinically diagnosed vitiligo patients were categorized into generalized (n = 30) or localized vitiligo (n = 30) and were further sub grouped according to their disease activity into active and stable groups. Thirty healthy volunteers were included in the control group. ELISA was used for the evaluation of MDA, SOD and r GSH. Results The patient group demonstrated significantly raised levels of MDA and significantly decreased levels of SOD and rGSH compared to the control group. Further, the OS parameters were significantly more deranged in patients with generalized disease (all three – MDA, rGSH, SOD) and an active disease (MDA) as compared to those with localized and stable disease respectively. Conclusion Our findings suggest an important role of OS in relation to vitiligo activity and severity. Although the OS parameters were deranged in all subsets of patients, with respect to controls, the derangement of oxidative damage marker (MDA) in generalized and active disease groups was most marked. Disease remains active when the oxidative damage becomes higher but is unmatched with the anti‐oxidant reserve which doesn't proportionately increase.
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Background: Several studies have investigated the oxidative stress parameters in alopecia areata (AA) patients with variable results. This study aims to analyze the association between oxidative stress and AA based on current literature. Methods: A systematic review of the existing literature was performed in PubMed, Scopus, and Cochrane databases by two authors independently. Mean and standard deviation values of oxidative stress parameters of AA patients and healthy controls were extracted for quantitative analysis. Results: A total of 18 studies were included in the analysis. Patients with AA had impaired oxidative balance with elevated levels of serum malondialdehyde, nitric oxide, and total oxidant capacity and lower levels of serum superoxide dismutase, paraoxonase, glutathione peroxidase, and total antioxidant capacity. Levels of oxidative parameters were significantly higher in severe AA compared to mild/moderate AA. Heterogeneity in the baseline characteristics of the included studies and limited available data for most parameters were the limitations of this study. Conclusions: Current evidence suggests that AA is associated with oxidative stress. More studies are needed to strengthen this association. Moreover, studies evaluating the role of antioxidant use in AA may be rewarding.
Article
Background Dermal papilla cells (DPCs) play a key role in hair regeneration and morphogenesis. Therefore, tremendous efforts have been made to promote DPCsʼ hair inductivity Objectives The aim of this study was to investigate the mitogenic and hair inductive effects of hypoxia on DPCs and examine the underlying mechanism of hypoxia‐induced stimulation of DPCs. Results Hypoxia significantly increased the proliferation and delayed the senescence of DPCs via Akt phosphorylation and downstream pathways. Hypoxia upregulated the growth factor secretion of DPCs through mitogen‐activated protein kinase pathway. Hypoxia‐preconditioned DPCs induced the telogen‐to‐anagen transition in C3H mice, and also enhanced hair neogenesis in a hair reconstitution assay. Injected GFP‐labeled DPCs migrated to outer‐root sheath of hair follicle, and hypoxia‐preconditioning increased the survival and migration of DPCs in vivo. Conditioned medium obtained from hypoxia increased the hair length of mouse vibrissa follicles via upregulation of alkaline phosphatase, vascular endothelial growth factor, and glial cell line‐derived neurotrophic factor. We examined the mechanism of this hypoxia‐induced stimulation, and found that reactive oxygen species (ROS) play a key role. For example, inhibiting of ROS generation by N‐acetyl‐L‐cysteine or diphenyleneiodonium treatment attenuated DPCsʼ hypoxia‐induced stimulation, but treatment with ROS donors induced mitogenic effects and anagen transition. NADPH oxidase 4 (NOX4) is highly expressed in DPCsʼ nuclear region, and NOX4 knockout by CRISPR‐Cas9 attenuated the hypoxia‐induced stimulation of DPCs. Conclusions Our results suggest that DPC culture under hypoxia has great advantages over normoxia, and is a novel solution for producing DPCs for cell therapy. This article is protected by copyright. All rights reserved.
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Hair loss is multifactorial. Antiandrogens are inconsistent in clinical results. Instead of fighting hair loss, we focus on strengthening the hair roots and promoting better hair growth. The article lists non-androgenic causes, enlists foods to be added and avoided for good hair growth, and provides scientific evidence for role of nutrients in hair loss management. New process of autophagy conceals clinical detection of low nutrient levels through lab tests. It is experimentally proven that DHT causes accumulation of ROS which in turn releases TGF ß1 leading to miniaturization, and this action can be successfully blocked by the use of antioxidants. Changing food preferences and decreasing nutritive value of the foods make it necessary to have supplements. Too many supplements consumed together reduce the absorption and efficiency of one another. Therefore, a low-dose once in 3 days cyclical vitamin therapy has been proposed. Nutritional correction ensures wellness, good health, and good hair growth without the fear of side effects.
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Introduction: dandruff is defined as excessive flaking of the scalp accompanied by itching. The etiology is multifactorial and depends on the presence of Malassezia yeasts, sebum production and individual susceptibility. Beyond traditional treatments to control dandruff, there are new formulations that may include keratolytics such as salicylic acid; climbazole, an antifungal agent which potential antiproteolytic properties, or terpineol, broad-spectrum antifungal with antiinflammatory action. Objective: the main objective of this study was to evaluate the effect on seborrheic dandruff of a shampoo with terpineol, willow extract, salicylic acid, climbazole and sebum-regulating lipoaminoacid, and a lotion with terpineol, salicylic acid, climbazole and glycosides from oak and green tea extract. Effectiveness on dry dandruff of a shampoo containing terpineol, willow extract, salicylic acid and climbazole was also evaluated. Three study visits were performed (T0, T28 and T42). Methods: single-center, open, non-randomized, single-blind, 42day study conducted in 78 patients with seborrheic or dry dandruff. Dandruff severity was classified into 4 grades. A shampoo for oily dandruff (A), a shampoo for dry dandruff (B), a lotion for oily dandruff (C) and a neutral shampoo (D) were administered. Four treatment groups were established according to the assigned treatment (A, B, AC and CD). Results: 59% of participants were women and 41% men. The average age was 47 years (range 2072). Of the total patients, 20 had medium-low oily dandruff (group A), 20 dry dandruff at any level (group B), 17 severe oily dandruff (AC) and 21 medium-high oily dandruff (group CD). After four weeks of treatment the severity of dandruff was reduced vs. baseline in =70% of cases in all groups; for oily dandruff results were 70% (low-medium grade), 76.2% (medium-high) and 88.2% (high level); the effect was most marked in patients with dry dandruff (90%). Dandruff removal was complete in 78.5%, 62.5%, 47% and 44.4% of them, respectively. Two weeks after having suspended the treatment, dandruff level continued to decline in 55% of patients treated with shampoo A, 57.1% of those who used the lotion C, 58.8% of patients who used shampoo A + lotion C, and 35% of those receiving shampoo B. Seventy per cent of patients in group A, 80% in group B, 66.7% of the CD group and 70.6% of the AD group were satisfied or very satisfied with the study treatments. Conclusions: the results obtained in this study suggest the effectiveness against oily and dry dandruff of two shampoos and a lotion based on terpineol, salicylic acid and climbazole. Further research to extend the results in this field is required.
Article
Objective: We evaluated the hair growth effect of ingesting a food containing proanthocyanidin. Methods: An open-label study consisting of 16 weeks was conducted. 29 healthy volunteers including 15 males and 14 females participated in this study. In each one-day of a study period, all subjects ingested a test food containing proanthocyanidin and tocotrienol. The dermatologist's evaluation for severity of hair loss, score of the scalp condition, and general improvement degree with photographic evaluation at the parietal region, and a subjective evaluation including sensory questions were conducted. Results: In the male group, 5 indexes of score of the scalp condition (inflammation, rash, amount of dandruff, pore-clogging, and sebum capacity) showed significant improvement compared with week 0 at week 16. There was no significant change in the Hamilton-Norwood scale. In the female group, severity of hair loss score, two indexes of score of the scalp condition (rash and amount of dandruff) showed significant improvement compared with week 0 at week 16. The subjective evaluation was improved significantly in the both groups compared with week 0 at week 16. No adverse effects were observed after the ingestion of the test food. Conclusion: These results implied that the test food was effective against the hair loss and pointed to its safety.
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Introduction: female androgenetic alopecia (FAGA) and telogen effluvium (TE) are common causes of hair loss in women. A known fact in these types of alopecia is the increased activity of 5a-reductase which reduces testosterone to dihydrotestosterone, accelerating hair cycle and shortening its duration. Serenoa serrulata is a plant species whose components have an inhibitory effect on 5a reductase. Objective: the main objective of this study was to evaluate the efficacy and tolerance against female alopecia of a food supplement with Serenoa serrulata extract, L-cystine, tocotrienol-tocopherol complex, iron, zinc, and vitamins H, B1, B2, B3, B5, B6 and B12 administered daily for six months. Material and Methods: single-center, open-label, nonrandomized, single-blind, 180-days pilot study conducted in women with FAGA or TE. The study assessed the macroscopic appearance of the hair, hair density by microphotograph, the anagen / telogen ratio (A/T) by trichogram, and the number of detached hair by combing and wash tests. Self-assessment survey of the results was performed. Results: the mean age of participants (n = 10) was 40 ± 15.5 years. FAGA and ET had an evolution of 4.5 ± two years and three months, respectively. After treatment the participants had an average increase of 6.9% in the proportion of hairs in anagen phase, and the mean A/T ratio increased to 3.3. Eighty percent or patients showed an increased capillary density at study end. After three months, all participants had a mean reduction of hair loss of 56% vs baseline. Ninety percent perceived a greater or equal amount of hair at the end of the study and 80% noticed it stronger. No adverse effects induced by treatment were observed. Conclusions: the good results of the analyzed variables suggest a therapeutic benefit against FAGA and ET. Additional research is warranted to confirm the observed data.
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To evaluate the tissue-specific distribution of lipophilic antioxidants including various vitamin E forms (tocotrienols and tocopherols) and oxidised and reduced coenzyme Q (ubiquinone and ubiquinol), a sensitive procedure was developed using gradient HPLC with both electrochemical- and UV-detection. A unique distribution of these antioxidants in hairless mouse tissues was found, suggesting that their distribution may be dependent upon selective mechanisms for maintaining antioxidant defences. Ubiquinol-9 was highest in kidney (81 ± 29 nmol/g) and in liver (42 ± 16 nmol/g), while the highest ubiquinone-9 concentrations were found in kidney (301 ± 123 nmol/g) and heart (244 ± 22 nmol/g). Liver contained nearly identical amounts of each ubiquinol-9 (41 ± 16 nmol/g) and ubiquinone-9 (46 ± 18 nmol/g). These mice were fed a commercial chow diet containing α-tocopherol (30 ± 6 mg/kg diet), γ-tocopherol (10 ± 1), a-tocotrienol (3.1 ± 0.7) and γ-tocotrienol (7.4 ± 1.7). Of the vitamin E forms, brain contained only α-tocopherol (5.4 ± 0.1 nmol/g; 99.8%) and no detectable tocotrienols. In other tissues, the α-tocopherol content was higher (20 nmol/g), while each of the other forms represented about 1 % of the total ( γ-tocopherol 0.2 to 0.4 nmol/g, a-tocotrienol 0.1, γ-tocotrienol 0.2). Remarkably, skin contained nearly 15% tocotrienols and 1% γ-tocopherol. The unique distribution of tocotrienols in skin suggested that they might have superior protection against environment stressors. Therefore, the penetration of topically applied vitamin E (tocotrienol enriched fraction of palm oil, TRF) and vitamin E homologue concentrations before and after exposure of skin to UV-light was assessed. 20 μL of 5% TRF in polyethylene glycol-400 (PEG) was applied to 2 skin sites and 20 μL PEG to 2 other sites. After 2 h, the skin was washed and half of the sites exposed to UV-irradiation using a solar simulator (2.8 mW/cm2 for 29 min). The vitamin E content of hairless mouse skin was: α-tocopherol 9.0 ± 1.0 nmol/g skin, γ-tocopherol 0.44 ± 0.03, a-tocotrienol 0.48 ± 0.07, γ-tocotrienol 0.92 ± 0.03. Topical TRF enriched skin vitamin E: α-tocopherol 201 ± 70 nmol/g skin, γ-tocopherol 37 ± 15, a-tocotrienol 53 ± 25, and γ-tocotrienol 50 ± 24. After UV-irradiation, concentrations of all vitamin E homologues from both treatment areas decreased significantly (p<0.01), but the TRF-treated skin contained vitamin E at concentrations 7- to 30-fold higher than control values. These findings provide provocative clues on the uptake and regulation of tissue lipophilic antioxidants. The unique distribution of these antioxidant substances suggests their distribution may be dependent upon tissue-specific selective mechanisms.
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One hundred women who presented with diffuse alopecia, were quantitatively evaluated for hair variables and compared with 20 controls. Fifty were selected for biochemical and haematological investigations, 44 of whom also underwent endocrine evaluation. Compared to controls, significant changes in hair values were found in the frontal area of all subjects, while 84% had significant changes in the occipital area. A biphasic distribution of hair diameter was evident in subjects who had percentages of vellus hair and telogen hair less than or equal to 30 mm in length that were above the control ranges. No significant difference between the mean hormonal values of women with diffuse alopecia and controls could be found. No correlation between hair values and individual or combined hormonal levels could be established. In 18 subjects (40.9%) hormonal values were within the control ranges and these apparently normal findings were often associated with adverse hair profiles. A raised dihydrotestosterone was found in 13 subjects (29.5%) and was the most frequently elevated androgenic finding. Seventeen (34.0%) had changes in iron metabolism, while in 36 (72.0%) serum ferritin levels were below the lowest control value. All had a decrease in the percentage of hair in the anagen growth phase compared to controls. The hair changes were similar to those observed in genetic hair loss in men, a proven androgen-dependent condition. We propose that diffuse androgen-dependent alopecia is the appropriate name to describe this condition in these women.
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The literature reveals what little is known about nutritional factors and hair loss. What we do know emanates from studies in protein-energy malnutrition, starvation, and eating disorders. In otherwise healthy individuals, nutritional factors appear to play a role in subjects with persistent increased hair shedding. Hård, 40 years ago, demonstrated the importance of iron supplements in nonanaemic, iron-deficient women with hair loss. Serum ferritin concentrations provide a good assessment of an individual's iron status. Rushton et al. first published data showing that serum ferritin concentrations were a factor in female hair loss and, 10 years later, Kantor et al. confirmed this association. What level of serum ferritin to employ in subjects with increased hair shedding is yet to be definitively established but 70 micro g/L, with a normal erythrocyte sedimentation rate (< 10 mm/h), is recommended. The role of the essential amino acid, l-lysine in hair loss also appears to be important. Double-blind data confirmed the findings of an open study in women with increased hair shedding, where a significant proportion responded to l-lysine and iron therapy. There is no evidence to support the popular view that low serum zinc concentrations cause hair loss. Excessive intakes of nutritional supplements may actually cause hair loss and are not recommended in the absence of a proven deficiency. While nutritional factors affect the hair directly, one should not forget that they also affect the skin. In the management of subjects with hair loss, eliminating scaling problems is important as is good hair care advice and the need to explain fully the hair cycle. Many individuals reduced their shampooing frequency due to fear of losing more hair but this increases the amount seen in subsequent shampoos fuelling their fear of going bald and adversely affecting their quality of life.
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Hair is considered to be a major component of an individual's general appearance. The psychological impact of hair loss results in a measurably detrimental change in self-esteem and is associated with images of reduced worth. It is not surprising that both men and women find hair loss a stressful experience. Genetic hair loss is the major problem affecting men and by the age of 50, up to 50% will be affected. Initial attempts to regenerate the lost hair have centred on applying a topical solution of between 2% to 5% minoxidil; however, the results proved disappointing. Recently, finasteride, a type II 5α reductase inhibitor has been found to regrow a noticeable amount of hair in about 40% of balding men. Further developments in treatments have lead to the use of a dual type I and type II inhibitor where 90% of those treated regrow a noticeable amount of hair. In women the major cause of hair loss before the age of 50 is nutritional, with 30% affected. Increased and persistent hair shedding (chronic telogen effluvium) and reduced hair volume are the principle changes occurring. The main cause appears to be depleted iron stores, compromised by a suboptimal intake of the essential amino acid L-lysine. Correction of these imbalances stops the excessive hair loss and returns the hair back to its former glory. However, it can take many months to redress the situation.
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To evaluate the tissue-specific distribution of lipophilic antioxidants including various vitamin E forms (tocotrienols and tocopherols) and oxidised and reduced coenzyme Q (ubiquinone and ubiquinol), a sensitive procedure was developed using gradient HPLC with both electrochemical- and UV-detection. A unique distribution of these antioxidants in hairless mouse tissues was found, suggesting that their distribution may be dependent upon selective mechanisms for maintaining antioxidant defences. Ubiquinol-9 was highest in kidney (81 ± 29 nmol/g) and in liver (42 ± 16 nmol/g), while the highest ubiquinone-9 concentrations were found in kidney (301 ± 123 nmol/g) and heart (244 ± 22 nmol/g). Liver contained nearly identical amounts of each ubiquinol-9 (41 ± 16 nmol/g) and ubiquinone-9 (46 ± 18 nmol/g). These mice were fed a commercial chow diet containing α-tocopherol (30 ± 6 mg/kg diet), γ-tocopherol (10 ± 1), α-tocotrienol (3.1 ± 0.7) and γ-tocotrienol (7.4 ± 1.7). Of the vitamin E forms, brain contained only α-tocopherol (5.4 ± 0.1 nmol/g; 99.8%) and no detectable tocotrienols. In other tissues, the α-tocopherol content was higher (20 nmol/g), while each of the other forms represented about 1 % of the total (γ-tocopherol 0.2 to 0.4 nmol/g, α-tocotrienol 0.1, γ-tocotrienol 0.2). Remarkably, skin contained nearly 15% tocotrienols and 1% γ-tocopherol. The unique distribution of tocotrienols in skin suggested that they might have superior protection against environment Stressors. Therefore, the penetration of topically applied vitamin E (tocotrienol enriched fraction of palm oil, TRF) and vitamin E homologue concentrations before and after exposure of skin to UV-Iight was assessed. 20 μL of 5% TRF in polyethylene glycol-400 (PEG) was applied to 2 skin sites and 20 p.L PEG to 2 other sites. After 2 h, the skin was washed and half of the sites exposed to UV-irradiation using a solar simulator (2.8 mW/cm2 for 29 min). The vitamin E content of hairless mouse skin was: α-tocopherol 9.0 ± 1.0 nmol/g skin, γ-tocopherol 0.44 ± 0.03, α-tocotrienol 0.48 ± 0.07, γ-tocotrienol 0.92 ± 0.03. Topical TRF enriched skin vitamin E: α-tocopherol 201 ± 70 nmol/g skin, γ-tocopherol 37 ± 15, α-tocotrienol 53 ± 25, and γ-tocotrienol 50 ± 24. After UV-irradiation, concentrations of all vitamin E homologues from both treatment areas decreased significantly (p<0.01), but the TRF-treated skin contained vitamin E at concentrations 7- to 30-fold higher than control values. These findings provide provocative clues on the uptake and regulation of tissue lipophilic antioxidants. The unique distribution of these antioxidant substances suggests their distribution may be dependent upon tissue-specific selective mechanisms.
Article
Objectives: To summarize new knowledge surrounding the physiological activity of tocotrienol, a natural analogue of tocopherol. Results: The biological activity of vitamin E has generally been associated with its well-defined antioxidant property, specifically against lipid peroxidation in biological membranes. In the vitamin E group, alpha-tocopherol is considered to be the most active form. However, recent research has suggested tocotrienol to be a better antioxidant. Moreover, tocotrienol has been shown to possess novel hypocholesterolemic effects together with an ability to reduce the atherogenic apolipoprotein B and lipoprotein(a) plasma levels. In addition, tocotrienol has been suggested to have an anti-thrombotic and anti-tumor effect indicating that tocotrienol may serve as an effective agent in the prevention and/or treatment of cardiovascular disease and cancer. Conclusion: The physiological activities of tocotrienol suggest it to be superior than alpha-tocopherol in many situations. Hence, the role of tocotrienol in the prevention of cardiovascular disease and cancer may have significant clinical implications. Additional studies on its mechanism of action, as well as, long-term intervention studies, are needed to clarify its function. From the pharmacological point-of-view, the current formulation of vitamin E supplements, which is comprised mainly of alpha-tocopherol, may be questionable.
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d-Alpha-tocopherol (2R,4'R,8'R-Alpha-tocopherol) and d-alpha-tocotrienol are two vitamin E constituents having the same aromatic chromanol "head" but differing in their hydrocarbon "tail": tocopherol with a saturated and toctrienol with an unsaturated isoprenoid chain. d-Alpha-tocopherol has the highest vitamin E activity, while d-alpha-tocotrienol manifests only about 30% of this activity. Since vitamin E is considered to be physiologically the most important lipid-soluble chain-breaking antioxidant of membranes, we studied alpha-tocotrienol as compared to alpha-tocopherol under conditions which are important for their antioxidant function. d-Alpha-tocotrienol possesses 40-60 times higher antioxidant activity against (Fe2+ + ascorbate)- and (Fe2+ + NADPH)-induced lipid peroxidation in rat liver microsomal membranes and 6.5 times better protection of cytochrome P-450 against oxidative damage than d-alpha-tocopherol. To clarify the mechanisms responsible for the much higher antioxidant potency of d-alpha-tocotrienol compared to d-alpha-tocopherol, ESR studies were performed of recycling efficiency of the chromanols from their chromanoxyl radicals. 1H-NMR measurements of lipid molecular mobility in liposomes containing chromanols, and fluorescence measurements which reveal the uniformity of distribution (clusterizations) of chromanols in the lipid bilayer. From the results, we concluded that this higher antioxidant potency of d-alpha-tocotrienol is due to the combined effects of three properties exhibited by d-alpha-tocotrienol as compared to d-alpha-tocopherol: (i) its higher recycling efficiency from chromanoxyl radicals, (ii) its more uniform distribution in membrane bilayer, and (iii) its stronger disordering of membrane lipids which makes interaction of chromanols with lipid radicals more efficient. The data presented show that there is a considerable discrepancy between the relative in vitro antioxidant activity of d-alpha-tocopherol and d-alpha-tocotrienol with the conventional bioassays of their vitamin activity.
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1. The purpose of this paper is to propose the measurement of scalp hair diameter as a useful index of protein synthesis in the management of cases of malnutrition. 2. Observations on scalp hair from ten control infants showed that each hair tapered very gradually towards its free end. 3. Observations on scalp hair from twenty-six infants with kwashiorkor showed that each hair narrowed towards the follicle; the effect was statistically significant. 4. After I month's treatment for kwashiorkor, scalp hair thickened towards the follicle and the effect was statistically significant. 5. Serial measurements of the greatest diameter at 0·5 mm intervals along the hair shaft had a main trend which was related to nutritional history. 6. The period of time over which narrowing of the hair shaft took place was calculated from the rate of hair growth and the serial diameter measurements: this time was always longer than the history of kwashiorkor.
Article
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.
Article
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.
Article
We investigated the contribution of reactive oxygen species to the development of sebaceous gland hyperplasia and the characteristics of the glutathione S-transferase/glutathione system in male pattern baldness. Glutathione S-transferase, glutathione, and thiobarbituric acid-reactive substances were determined in sebaceous gland-enriched scalp skin of men affected by male pattern baldness and were subjected to hair autotransplantation. In comparison with the hairy occipital-donor areas, the following results were obtained in alopecic frontoparietal samples: glutathione S-transferase-specific activity increased 7-fold (p < 0.001); enzyme affinity towards 1-chloro-2,4-dinitrobenzene decreased 2-fold (p = 0.009); glutathione content decreased 2.5-fold (p = 0.017); and thiobarbituric acid reactive substances increased 2-fold (p = 0.006). Chromatofocusing analysis, bromosulfophthalein IC50 values, enzyme-linked immunosorbent assay, and immunohistochemistry with polyclonal antibodies raised against glutathione S-transferases alpha, mu, and pi demonstrated the presence of alpha, pi, and probably the 5.8 alpha isoenzymes in the sebaceous gland. These results support the hypothesis that reactive oxygen species are involved in the pathogenesis of sebaceous gland hyperplasia in male pattern baldness.
Article
Male pattern baldness, or androgenetic alopecia (AGA) in men, occurs with varying severity and age of onset. Two new treatments widely available as alternatives to 2% minoxidil are 1 mg finasteride and topical 5% minoxidil. Finasteride is a 5 alpha-reductase inhibitor available by prescription only; 5% minoxidil is available over the counter. We searched MEDLINE to identify all articles on AGA and its pharmacologic therapies. We found limited information on AGA in peer review medical journals. Associated diseases include psychologic disorders and coronary heart disease. Hair growth is unpredictable and limited for all pharmacologic therapies, with the vast majority of treatment studies being industry sponsored. AGA is not easy to treat. Finasteride and 5% minoxidil offer new therapeutic options to the balding man. Treatment options may improve as new drugs are further investigated.
Article
The aim of this research was to determine levels in blood of vitamin E, beta-carotene, lipid peroxidation as thiobarbituric-acid reactive substances (TBARS) and reduced glutathione (GSH) and activity of glutathione peroxidase (GSH-Px) in patients with alopecia. Studies were carried out on 37 patients with alopecia and 34 healthy age-matched controls. Red blood cell (RBC) and plasma samples from healthy and patient subjects were taken. Beta-cartotene levels (P<0. 001) in plasma and levels of GSH (P>0.05) and the activity of GSH-Px (P<0.05, P<0.01) in both plasma and RBC samples were significantly lower in patients with alopecia than in controls, whereas TBARS levels in plasma (P<0.05) and RBC (P<0.001) samples were significantly higher in patients with alopecia than in controls. However, vitamin E levels in plasma did not differ statistically. Although being far from conclusive, these results provide some evidence for a potential role of increased lipid peroxidation and decreased antioxidants in alopecia.
Article
Hair, especially scalp hair, is imbued with greater social and psychological significance than with biological importance. Hair provides some cranial cushioning and shielding from the sun’s rays; however, throughout history and across cultures, hair conveys considerable symbolism.1‐3 It can serve as a social signal of gender, age, status, values, and group membership. From monks to skinheads, prisoners of war to warriors, “bigwig” European aristocrats to moptop Beatles, and hippies to head-shaven celebrity athletes, hair makes a statement, whether chosen or imposed. Beyond its sociological meanings, hair can become an essential part of self-identity or “body image.” Body image is a psychological concept that refers to one’s perceptions, thoughts, feelings, and behaviors related to one’s physical appearance.4 For many people, hair is a physical attribute that expresses individuality and is central to feelings of attractiveness or unattractiveness. Indeed, scalp hair is rather unique as an actual part of the human body that is readily malleable in altering or managing one’s physical appearance. In a relatively short time, one can color, cut, curl, and/or restyle one’s hair to create the visual image one desires. In contrast, other bodily transformations require substantial time and effort (eg, loss of weight or increase in muscle definition), involve artificial adornments (eg, clothing, cosmetics, and jewelry), or entail surgical procedures (eg, a face lift). For many people (and other primates), hair is a focal aspect of a daily grooming ritual. Preparing one’s hair is preparation to face one’s social world. The expression “bad hair day” is testimony to the psychological importance of hair. Hair loss can turn every day into a bad hair day. The purpose of the present article is to provide the practicing dermatologist useful information and insights about the psychological effects of hair loss, particularly androgenetic alopecia (AGA). This clinically oriented presentation draws upon the scientific literature on the psychosocial sequelae of hair loss5,6 and contemporary perspectives concerning the psychology of physical appearance.4,7,8
Article
Finasteride, a type II 5alpha-reductase inhibitor, reduces scalp and serum dihydrotestosterone and has been shown to be effective in men with androgenetic alopecia (AGA). The purpose of this study was to determine the effect of finasteride on scalp hair weight in men with AGA. Sixty-six men with AGA received finasteride, 1 mg/d, or placebo in a 48-week study, and 49 men continued in a 48-week extension. Efficacy was assessed by scalp hair weights and hair counts. As expected, hair counts improved with finasteride (net mean percent change +/- SE [95% CI] compared with placebo = 9.2% +/- 2.8% [3.8, 14.6] and 15.4% +/- 3.2% [9.1, 21.7] at 48 and 96 weeks, respectively; P <.01 for both time points), and net improvements in hair weight were greater (25.6% +/- 3.6% [18.5, 32.7] and 35.8% +/- 4.6% [26.7, 44.8] at 48 and 96 weeks, respectively; P <.001 for both time points). Finasteride was generally well tolerated. In this study, finasteride, 1 mg, increased hair weight in men with AGA. Hair weight increased to a larger extent than hair count, implying that factors other than the number of hairs, such as increased growth rate (length) and thickness of hairs, contribute to the beneficial effects of finasteride in treated men.
Article
Alopecia areata (AA) is an autoimmune inflammatory disease. However, little is known about the alterations in lipid peroxidation and antioxidant enzymes in the scalp of patients with AA. Therefore, the aim of this study was to investigate the status of oxidative stress in the scalp of patients with AA. We measured the levels of thiobarbituric acid reactive substances (TBARS) as lipid peroxidation status, superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) as antioxidant enzymes in the scalp of ten patients with AA and ten control subjects. The levels of TBARS in scalp of patients with AA (3654.1+/-621.2 nmol/g tissue) were significantly higher than those of controls (1210.2+/-188.8 nmol/g tissue) (P=0.002). The levels of SOD (134.8+/-23.8 U/g tissue) and GSH-Px (332.7+/-66.2 U/g tissue) in scalp of patients with AA were also significantly higher than those of controls (63.2+/-8.8 U/g tissue, 112.0+/-18.4 U/g tissue, respectively) (P=0.019, P=0.002, respectively). The mean levels of TBARS, SOD and GSH-Px in early phase of disease were increased 2-fold as compared with late phase of the disease. These results indicate that oxidative status is affected in AA. Lipid peroxidation and antioxidant enzymes may be involved in the pathogenesis of AA. Furthermore, we found high SOD and GSH-Px activities in the scalp of patient with AA. These high levels could not protect the patients against the reactive oxygen species, because lipid peroxidation could not be lowered in AA patients.
Article
We attempted to establish a coculture model of human dermal papilla cells (DPCs) from androgenetic alopecia (AGA) and keratinocytes (KCs) to study the pathomechanism of AGA. Since expression of mRNA for the androgen receptor (AR) decreased during subcultivation of DPCs in vitro, we transiently transfected the AR expression vector into the DPCs and cocultured them with KCs. In this coculture, androgen inhibited the growth of KCs by 50%, indicating that the DPCs produce diffusible growth suppressive factors into the medium in an androgen-dependent manner. Since recently increasing evidence has shown the importance of transforming growth factor-beta1 (TGF-beta1) in hair growth, we further examined the concentration of TGF-beta1 in this coculture medium after androgen treatment by ELISA assays. The results showed that androgen treatment increased the secretion of TGF-beta1 into the conditioned medium. Moreover, neutralizing anti-TGF-beta1 antibody reversed the inhibition of KC proliferation. Thus, we suggest that androgen-inducible TGF-beta1 derived from DPCs mediates hair growth suppression in AGA.
Article
The pathophysiology of alopecia areata (AA) has not been clearly defined; however, it appears as a tissue-restricted autoimmune disease mediated by T lymphocytes. Immunohistochemical studies have shown peri- and infra-follicular inflammatory infiltrate which damages hair follicles. We analyzed the role of lipid peroxidation and oxidant-antioxidant enzymes in the pathogenesis of AA. Twenty-four patients with AA and 20 age- and sex-matched healthy controls were enrolled in this study. We analyzed serum levels of malondialdehyde (MDA) and nitric oxide (NO) and the serum activities of superoxide dismutase (SOD) and xanthine oxidase (XO) in patients with AA and control subjects. The levels of MDA and NO (nitrite/nitrate) and the activity of XO in serum of patients with AA (0.76+/-0.34 nmol/ml, 14.88+/-6.40 nmol/ml, and 0.34+/-0.10 U/ml, respectively) were significantly higher than those of controls (0.35+/-0.09 nmol/ml, 10.71+/-1.75 nmol/ml, 0.11+/-0.03 U/ml; p<0.001, p<0.001, p<0.05, respectively). The SOD activity (12.95+/-2.16 U/ml) in the serum of patients with AA was significantly lower than that of controls (14.89+/-2.29 U/ml, p<0.05). Increased lipid peroxidation in AA may be related to an increase in NO level and XO activity and a decrease in SOD activity. These results suggest that lipid peroxidation and alterations in the oxidant-antioxidant enzymatic system may play a role in the pathogenesis of AA.
The involvement of ROS on androgen inducible TGF beta 1 regulation derived from dermal papilla cells; a suggestive implication of ROS on androgenetic alopecia
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