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Effects of Ganoderma Lucidum Extract Ethanol Extract and Microneedle Therapy System on Hair Growth in an Alopecia Model of C57BL/6N Mice
Abstract
Objectives This study was carried out to investigate the effect of Ganoderma lucidum extract (GLE) and microneedle therapy system (MTS) on hair growth in an alopecia model of C57BL/6N mice. Methods Five-week old mice were depilated and separated in 4 groups ; CON (50% EtOH), MXD (5% Minoxidil), MTS and GLE + MTS. The treatments were applied twice a week for 3 weeks. The hair growth was determined photographically, the hair density, thickness and length were identified by Folliscope and the weights of body and organs were measured. In dorsal skin tissue, the expression of hair growth-related gene and protein was analyzed by RT - PCR or Western blot. In addition, the hair follicles in the dermis were observed by H&E staining. Results The promotion of hair growth was observed in GLE + MTS and MTS compared to CON. The hair density, thickness and length were also improved in GLE + MTS and MTS compared to CON. The mRNA expression of TGF-{\alpha}, TGF-{\beta}1, IGF-1, PRL and PL and the protein expression of VEGF and IGF-1 were increased in GLE + MTS and MTS compared to CON. The hair follicles and hair root growth were improved in GLE + MTS and MTS compared to CON. In the above results, GLE + MTS were more effective than MTS. Conclusions These results suggest that GLE and MTS has a hair growth activity and can be useful for the treatment of alopecia.
... Lee et al. [8] studied the hair growth effect by comparing the control group, the Minoxidil group, and the MTS group. Ju et al. [9] studied the hair growth effect by comparing the control group, the Minoxidil group, the MTS group, and the MTS + Ganoderma lucidum extract (GLE) group. Kang et al. [10] studied the hair growth effect by dividing the group into four groups as follows: the control group, the Minoxidil group, the MTS group, and the MTS + Hwangryeonhaedoktang Pharmacopuncture Solution (HRHDT) group. ...
... Lee et al. [8] analyzed hair growth effect by visual observation using dermoscopy; by observation of hair follicles with hematoxylin and eosin staining after biopsy; and by testing antibody of bromodeoxyuridine (BrdU), fibroblast growth factor (FGF), and vascular endothelial growth factor (VEGF) by immunohistochemistry and PT-PCR. Ju et al. [9] and Kang et al. [10] evaluated the hair growth effect by visual observation after pulling out hair to observe the hair length. The density and diameter of the hair were observed using a Folliscope. ...
... They used dermoscopy, biopsy, immunohistochemistry, and RT-PCR to examine the hair growth effect, wherein they confirmed an increase in hair density, hair diameter, and hair growth. Ju et al. [9] performed the study in four groups as follows: the control group, the Minoxidil group, the MTS group, and the MTS + GLE group and analyzed the hair growth effect by visual inspection, Folliscope, biopsy, and RT-PCR. Nonetheless, the stress and side effects were observed by measuring the body weight and organ weight of experimental mice. ...
Objectives:
The purpose of this study was to analyze the microneedle therapy system (MTS) and its research methods for the past 10 years in Korea.
Methods:
Data on microneedle therapy system were collected using NDSL, KISS, RISS, and OASIS electronic databases from January 2010 to August 2021. "microneedle," "derma stamp," "microneedle therapy system" were used as the keywords. The present study, however, excluded data that were 1) unrelated to the microneedle therapy system, 2) from review/meta/protocol studies, and 3) from overseas studies. Data selected through the primary screening process, animal studies, case reports, and clinical data were included in the analysis. However, information data not related to the microneedle therapy system were excluded from the study.
Results:
Among the MTS-related papers published from January 2010 to August 2021, 7 animal research, 2 clinical trials, and 10 case studies were published. Based on the research topics, there were 8 papers on skin improvement and skin diseases, 7 papers on hair growth and hair loss, 3 papers on stability, and 1 paper on peripheral facial paralysis.
Conclusion:
Most of the studies related to MTS focused on skin, hair, and stability. The effect of MTS on hair growth and skin improvement has been confirmed, and it has been proven to have significant effects on the treatment of acne, acne scars, and hair loss in clinical practice. No serious side effects were observed during the MTS treatment, and the safety assessment confirmed that it was safe for use.
... In 3 studies [5][6][7], the control group, the MXD group, and the MTS group were compared. In addition, in 2 of the 3 studies [8,9], the combination of Korean herbal extract (Hwangyeonhaedoktang and Yeongji extract) and the MTS was also examined. ...
... In a 3-week study [9], the greatest effect was observed when the rolling was performed 10 times with a 0.25 mm or 0.5 mm needle. In other in vivo studies, the MTS was performed 2-3 times per week for 16 to 21 days [6,8,9]. In all studies, the density and thickness of the hair were observed through a folliscope or dermoscopy. ...
... Hematoxylin and eosin stain were used to perform histological observations of the size and number of the hair follicles, and the length of the hair bulb. Vascular endothelial growth factor (VEGF), insulin-like growth factor, prolactin, transforming growth factor, fibroblast growth factor (FGF), epidermal growth factor (EGF), Wnt3α, Wnt10β, and β-catenin levels were measured by immunohistochemical staining, Western blot, and real-time polymerase chain reaction (RT-PCR) [6][7][8][9]. In the comparative studies with MXD, the MTS had a significant effect on almost all indices of hair growth compared with the control group, although the effect was not as beneficial as MXD treatment. ...
This literature review was designed to investigate the effects of the microneedle therapy system (MTS) on alopecia in experimental, and clinical studies. The MTS is acupuncture needling therapy delivered by a roller. A literature review of studies published before May 2020 was conducted using 9 online databases, and a total of 13 studies (4 in vivo studies and 9 clinical trials) were included. Most studies showed that the MTS was effective when used in combination with other treatments. In vivo studies reported an increased level of hair growth factors following treatment. Typically, 1.5 mm needles were used in the MTS treatment and photographic evaluation (by either camera or microscope) was reported in most studies. Oriental medicine research included 2 in vivo studies, which reported positive effects when combined with the MTS. There were no reported severe side effects. the MTS might be safe and has a drug delivery effect. Further studies need to be conducted regarding the frequency and needle length depending on the type of alopecia using Oriental and Western medicine.
... Traditional medicine treatments for alopecia include herbal medicine [6][7][8], bee venom pharmacopuncture [9], pharmacopuncture [10,11] and the application of Saengbal-eum [12]. In recent years, plum-blossom needling [13], microneedle therapy system [14,15], and threadembedding therapy [16] have also been used. Sebalgukhwa-san is a prescription derived from Eyakwonbang [17], composed of Chrysanthemi Indici Flos, Cnidii Rhizoma, Morus alba Linn, Viticis Fructus, Angelicae Dahuricae Radix, Asia Radix, Ecliptae Herba and Thujae Orientalis Folium. ...
Background This study was conducted to evaluate the effects of pharmacopuncture and dermal application of Sebalgukhwa-san extracts on hair growth in an alopecia mouse model. Methods Twenty-one C57BL/6 mice were divided into 3 groups; control group-normal saline injection or vehicle solution application, positive control group-minoxidil (MNXD), experimental group-pharmacopuncture and applied Sebalgukhwa-san (SGS) extract. The effects of the treatment on hair growth, were determined through photographs, and phototrichogram analysis by folliscope. Hair follicle morphometry by hematoxylin-eosin staining was performed, and hair growth-related protein expression of vascular endothelial growth factor, insulin like growth factor-1, and transforming growth factor-beta 1 were monitored by Western blotting. Serum levels of aspartate aminotransferase and alanine aminotransferase were measured for liver function test. Results Body weight increased consistently in all groups. Hair growth was improved in the MNXD and SGS groups compared with the control. Hair density and thickness improved statistically significantly in the MNXD and SGS groups compared with the control p < 0.05. The number of hair follicles improved in the MNXD and SGS groups compared with the control but the size did not. The expression of vascular endothelial growth factor and insulin like growth factor-1 increased, and there was a decrease in the expression of transforming growth factor-beta 1 in the MNXD and SGS groups compared with the control, however, there was no significant difference. Sebalgukhwa-san treatment had no toxicity in liver function tests. Conclusions Pharmacopuncture and dermal application of Sebalgukhwa-san extract may be therapeutically beneficial for the treatment of alopecia.
... 脫毛의 원인은 內 因과 外因으로 구분되며, 內因으로는 腎虛, 血熱, 氣 血虛, 瘀血, 七情 등이 있고, 外因으로는 風邪, 風熱, 濕熱, 火 등이 있다 10) . 지금까지 탈모의 치료에 대한 논문은 한약과 약침 치료11,12) , 매선 13) 등 증례보고가 있으며 실험적 연구로는 추출물을 이용한 연구[14][15][16] ...
Objective : This study was carried out to investigate the effect of Hwangryeonhaedoktang pharmacopuncture solution (HRHDT) and microneedle therapy system (MTS) on hair growth in an alopecia model of C57BL/6N mice.Methods : Six-week old mice were depilated and separated in 4 groups ; CON (saline), MXD (3% Minoxidil), MTS and HRHDT+MTS. The treatments were applied twice a week for 17 days. The hair growth was determined photographically. The hair density, thickness and length were identified by Folliscope and the weights of body and organs were measured. In dorsal skin tissue, the expression of hair growth-related gene and protein was analyzed by RT-PCR. In addition, the hair follicles in the dermis were observed by H&E staining.Results : The promotion of hair growth was observed in HRHDT+MTS and MTS compared to CON. The hair density, thickness and length were also improved in HRHDT+MTS and MTS compared to CON. The mRNA expression of IGF-1, PRL and PL and the protein expression of VEGF and IGF-1 were increased in HRHDT+MTS and MTS compared to CON. The hair follicles and hair root growth were improved in HRHDT+MTS and MTS compared to CON. In the above results, HRHDT+MTS were more effective than MTS.Conclusions : These results suggest that HRHDT and MTS have a hair growth activity and can be useful for the treatment of alopecia.
Objectives : We studied on anti-allergic effects of Ganoderma lucidum herbal acupuncture(GHA) and Ganoderma lucidum extract(GE).
Methods : in vivo, Animals were herbal-acupunctured GHA at both B13s three times for 5 days. Then, we investigated compound 48/80-induced active systemic anaphylatic shock using ICR mice and anti-DNP IgE-induced passive cutaneous anaphylaxis using Sprague Dawley rat. In vitro, we measured cell viability, b-hexosaminidase release, IL-4 and TNF-a from RBL-2H3 cells, and nitric oxide from Raw264.7 cell after treatment of GE of various concentrations.
Results : In vivo, GHA pretreatments at both B13s inhibited compound 48/80-induced active systemic anaphylatic shock. Passive cutaneous anaphylaxis were inhibited by GHA10 and OP. In vitro, 0.1 ~ 2% GE treatments were not affect on cell viability and inhibited b-hexosaminidase release, IL-4, TNF-a and nitric oxide.
Conclusions : These results suggest that GHA and GE may be beneficial in the inhibition of allergic inflammatory response.
This study developed a novel microneedle design to inject drug and other solutions into the skin. Using a polymer core supported by an external metal coating for structural support, a laser was used to drill the hollow needle bore off center. This produced a hollow needle with a side opening that was strong enough to insert into skin. INTRODUCTION Arrays of hollow microneedles have been proposed to achieve painless injection and infusion of drug solutions into the skin [1-3]. Using the tools of microfabrication, a variety of hollow microneedle designs have been developed and a limited number have been demonstrated to deliver drug into skin. Most hollow microneedles have been fabricated out of silicon, which is not yet known to be safe for human use. Some have been fabricated out of metal, which can provide strong needles made of FDA-approved materials. In our previous work, we fabricated solid microneedles having a number of different designs, including polymer microneedles with extremely sharp tips (1 – 10 µm), as shown in Figure 1A [4]. We also fabricated hollow metal microneedles which have less sharp tips (30 – 80 µm) because the hollow bore opening is at the needle tip, as shown in Figure 1B [5] Although these blunt-tipped microneedles can insert into skin and deliver drug, hollow metal microneedles with sharp tips would be easier to insert and less prone to clogging. This observation motivated the present study, which uses sharp-tipped, solid, polymer microneedles as a core structure that is coated with metal to provide added strength. By drilling the hollow needle bore off center, tip sharpness can be retained.
Insulin-like growth factor-I (IGF-I) shares a high degree of structural and functional homology with insulin and is a potent mitogen supporting cell growth and survival in many kinds of the tissues and cells. It also plays a role in some differentiation and anti-apoptotic functions. In previous reports, it has been shown that IGF-I stimulates hair follicle (HF) growth, maintains the anagen stage, and postpones the catagen stage.
The exact mechanism of the effect of IGF-I on HF growth is not yet established. Therefore, we investigated the relationships between IGF-I and various other factors (i.e. apoptosis related molecules, pro-inflammatory cytokines, other growth factors, etc.) in the control of HF growth.
The effect of IGF-I on human hair growth was measured using an organ culture model of human HFs and compared with a control group that did not receive IGF-I. We also measured mRNA expression of factors related to hair growth and apoptosis (which was determined by reverse transcription polymerase chain reaction (RT-PCR). RT-PCR was done on days 2, 4, 6, and 8 of organ culture.
In organ cultured human hair follicles, IGF-I had a positive effect on the rate of linear hair growth. IGF-I maintained the anagen phase. IGF-I increased the expression of platelet-derived growth factor (PDGF)-A, PDGF-B and the expression ratio of Bcl-2/Bax.
The effect of IGF-I on hair growth appears to be related to the upregulation of PDGF-A and PDGF-B and to the anti-apoptotic effect of IGF-I.
The technology of fabricating microneedle arrays to deliver high molecular weight drugs across skin in a minimally invasive manner is receiving increasing attention. Microneedle arrays with different geometries have been manufactured using materials such as glass, polymer, metal, etc. However, a framework that can identify the optimum designs of these arrays seems to be lacking. This is important since by optimizing the microneedles dimensions (e.g., surface area of the patch, microneedle radius, etc.) the permeability of drugs in skin can be increased. To address this issue, this study presents an optimization framework for transdermal delivery of high molecular weight drug from microneedle. The optimization process is based on determining an optimization function (g) for various microneedles patterns (e.g., square, diamond, triangular, etc.). We argue that higher the value of g is the higher the drug permeability in skin is. The outputs of the developed framework have allowed us to identify the optimum design of both solid and hollow microneedles. In particular, the results have been used to predict skin permeability of high molecular weight using microneedle system. Also, optimum designs based on different classifications of skin thickness (e.g., race, age, etc.) for transdermal delivery of drugs are suggested.
According to the bibliographic studies of Depilation, the following conditions were made after literary studies.; 1. According to the period, The depilation have been named variously, for example, Balta(髮墮), Balgu(髮去), Balrak(髮落), Mobal(毛拔), Yupung(油風), Dokchang(禿瘡), Guijidu(鬼?頭), Dokban(禿班), etc. 2. The cause of depilation was deficiency of kidney(腎虛), defciency of Qi of the lung(肺氣虛), excessive heat of blood system(血熱), deficiency of Qi and blood system(氣血虛), deficiency of blood system(血虛), and endogenouse cause of, etc. 3. The depilation is meaning fallen hair in head. There are multiform type in the symptoms of depilation; round shape, ellipse type & bald head. 4. The herbal treatment was used Yukmijihwaghwan(六味地黃丸), Palmihwan(八味丸), Singihwan(腎氣丸), Hwangigunjungtang(黃耆建中湯), Samultang(四物湯), ect. and external herbal reatment was Sineungyangjindan(神應養鎭丹), Bangpungtongsungsan(防風通聖散), ect.
Background: Various topical cosmeceuticals and lasers have been used to treat photo-aged skin that has wrinkles, acne scars and dilated pores. The microneedle therapy system (MTS) that mechanically makes multiple holes on the skin has come into the limelight to treat these skin problems via stimulating collagen remodeling. The automicroneedle therapy system (AMTS) is a developed version of MTS and it has several advantages compared with conventional MTS. AMTS can achieve regular treatment results because of its automatically punching method. In addition, AMTS can treat smaller area and it has cost advantages due to the inexpensive disposable needle head. Objective: This study was designed to determine the dermal proliferative effects and safety of AMTS on the skin compared with that of the conventional MTS roller. Methods: Twelve hairless mice were divided into two groups; one group was treated with a 0.25 mm needle and the other group was treated with a 2 mm needle. The first group was subdivided into the AMTS-H and the MTS groups and the no treatment group as a control, while the second group was subdivided into the AMTS-H, AMTS, MTS and control groups. Each treated group underwent four procedures every other day. The dermal proliferative efficacies of the treatment were evaluated by the histology, including the dermal thickness and the densities of the collagen fibers. Western blot was also performed for the evaluation of the protein expression of procollagen type I and matrix metalloproteinase-13. For safety profiles, we performed gross observation, basal skin barrier function testing and histologic examination. Results: Treatment by AMTS significantly increased dermal collagen synthesis and the dermal thickness in the hairless mice. In addition, the expression of procollagen type I protein was increased, which accounted for the increased dermal collagen density. There was no specific safety problem related to the treatment. Conclusion: These results indicated that AMTS is an effective, safe modality for treating skin problems that require dermal proliferation. We anticipate that AMTS could be a new therapeutic option for inducing dermal proliferation or regeneration.
Objectives This clinical study is aimed to examine the effects of herbal medication and pharmacopunture on child with different types of alopecia. Methods 13 year old girl was treated with Hominis placenta pharmacopuncture microneedle therapy system and Ganoderma lucidum pharmacopuncture mesotherapy on the alopecia lesion for 20 months. Herbal medication, meridian pharmacopuncture therapy and physiotherapy were also used to reduce physical symptoms. Results The patient had a relapse of hair loss with changing alopecia types, but eventually alopecia has been resolved and maintained throughout the Korean medicine treatment. Conclusions This study shows the effect of the Korean medical treatments for a pediatric patient with alopecia. And more research is needed to study about patients with different types of alopecia.
The domestic market for scalp care and hair loss management reached 1 trillion won. The market for hair loss management is expected to expand further. Systematic scalp and hair care services, such as scalp scaling, scalp massage, equipment maintenance, scalp care products sale, and care program based on scalp and trichology are provided. This study examined the status of hair loss management and use of hair care products by people experiencing hair loss and the level of their satisfaction. In addition, this study presents basic data for the effective hair loss management and marketing strategies for scalp and hair loss clinics. The results are as follows. 41.2% of the study subjects were in their 20s, and 66.6% of the study subjects were women. As for the hair loss symptoms, 45.2%, the largest percentage, had thin and wispy hair and more women had thin hair than men. 80.0% of men had oily hair. As for the scalp condition, 39,3% had oily scalp. As more women experience hair loss, 39.6% had female pattern hair loss and 31.0% had male pattern hair loss. As the largest percentage of people experiencing hair loss was in their 20s, 33.4%, the largest percentage, had the onset of hair loss in their early 20s. 34.1%, the largest percentage, reported having used the clinic for less than 1 month. The older the subject, the longer the length of hair clinic use. As for the average number of monthly hair loss clinic visits, 28.2%, the largest percentage, said 3 times. As for the hair loss management product use, 61.9%, said they do not use it and 38.1% said they use it. 5.6%, the largest percentage, used Davines at home and 9.6%, the largest percentage, used Kerastase at the clinic. As for the experience of hair loss product previously, 84.5% said they had no experience and 15.5% said they had eThe following are related to the satisfaction level of hair loss management. xperience. 5.0%, the largest percentage, reported having used Daenggimeori. The following are related to the satisfaction level of hair loss management. 32.8%, the largest percentage, said the effect of hair loss management lasted less than 6 monthas. As for the satisfaction levels on hair loss management program, service, skill of the hair specialist, hygiene, and hair loss management products, most people indicated between average and somewhat satisfactory levels. As for the satisfaction level on the cost of hair loss management, most people indicated average satisfaction level. As for the element essential to hair loss management, 39.0%, the largest percentage, indicated development of effective and specialized programs, 28.2%, indicated low price, 25.1%, indicated systematic and professional education of the hair specialist, 4.6%, indicated marketing and promotion, 2.5%, indicated service quality, and 0.6% indicated others.
Observations performed in a subset of subjects treated with finasteride (an inhibitor of the enzyme 5α-reductase) for male pattern hair loss seem to indicate that sexual dysfunction as well as anxious/depressive symptomatology may occur at the end of the treatment and continue after discontinuation.
A possible hypothesis to explain depression symptoms after finasteride treatment might be impairment in the levels of neuroactive steroids. Therefore, neuroactive steroid levels were evaluated in paired plasma and cerebrospinal fluid samples obtained from male patients who received finasteride for the treatment of androgenic alopecia and who, after drug discontinuation, still show long-term sexual side effects as well as anxious/depressive symptomatology.
The levels of neuroactive steroids were evaluated by liquid chromatography-tandem mass spectrometry in three postfinasteride patients and compared to those of five healthy controls.
Neuroactive steroid levels in plasma and cerebrospinal fluid of postfinasteride patients and healthy controls.
At the examination, the three postfinasteride patients reported muscular stiffness, cramps, tremors, and chronic fatigue in the absence of clinical evidence of any muscular disorder or strength reduction. Severity and frequency of the anxious/depressive symptoms were quite variable; overall, all the subjects had a fairly complex and constant neuropsychiatric pattern. Assessment of neuroactive steroid levels in patients showed some interindividual differences. However, the most important finding was the comparison of their neuroactive steroid levels with those of healthy controls. Indeed, decreased levels of tetrahydroprogesterone, isopregnanolone and dihydrotestosterone and increased levels of testosterone and 17β-estradiol were reported in cerebrospinal fluid of postfinasteride patients. Moreover, decreased levels of dihydroprogesterone and increased levels of 5α-androstane-3α,17β-diol and 17β-estradiol were observed in plasma.
The present observations confirm that an impairment of neuroactive steroid levels, associated with depression symptoms, is still present in androgenic alopecia patients treated with finasteride despite the discontinuation of the treatment. Melcangi RC, Caruso D, Abbiati F, Giatti S, Calabrese D, Piazza F, and Cavaletti G. Neuroactive steroid levels are modified in cerebrospinal fluid and plasma of postfinasteride patients showing persistent sexual side effects and anxious/depressive symptomatology. J Sex Med **;**:**-**.
Hypertrichosis is a well-recognized adverse effect of therapy with either oral or topical minoxidil. We report a case of fronto-temporal hypertrichosis occurring in an 8-year-old girl treated for patchy alopecia areata of the frontal area of the scalp with 2% minoxidil solution. After failure of 5-months minoxidil-discontinuation, hair removal with Nd:YAG laser (1064 nm line) (Smartepil II, Deka) was tested leading to complete resolution within 2 sessions.
Androgenetic alopecia is the most common type of hair loss in men and women. The disorder represents a quantitative phenotype with an underlying genetic disposition. So far none of the causative genes have been identified. Under the influence of androgens there is a shortening of the anagen phase as well as a reduction of the cellular hair matrix volume in the involved scalp area. This results in the transformation of thick terminal hair follicles into thin vellus-like hair follicles. Clinically, patients present with an alopecia that follows a defined pattern (pattern baldness) and progresses continuously but in varying degrees. In advanced cases, men may develop baldness with remaining hair exclusively in the temporal and occipital regions. Women are prone to exhibit a more diffuse type of hair loss with pronounced thinning in the parietal region. Whereas the diagnosis of androgenetic alopecia is easy, its treatment is often difficult. The physician is commonly confronted with high patients' expectations regarding hair regrowth. Today, with minoxidil and finasteride, effective therapies are available which can lead to cessation of hair loss. The identification of underlying genes will make a more specific therapy easier to achieve.
The pathogenesis of hair loss, the postulated mechanisms of minoxidil action on hair growth, and clinical trials, adverse reactions, experimental formulations, and percutaneous absorption of topical minoxidil preparations are reviewed. Topical minoxidil seems to normalize hair follicles and increase blood flow to the scalp. In clinical trials of various formulations, results have varied. Improved hair growth occurred after four to six months of therapy; twice-daily application seems to be indicated. The most frequently reported adverse reactions are mild scalp dryness and irritation and, rarely, allergic contact dermatitis. Current recommendations are to reserve topical minoxidil for patients with normal cardiovascular status and to routinely monitor blood pressure, heart rate, and electrocardiographic changes. A new drug application is pending with FDA for use of topical minoxidil in androgenetic alopecia (male-pattern baldness), which is genetically determined and apparently stimulated by androgens. For alopecia areata, which involves hair loss on the body or scalp, usually patchy and of sudden onset, no reliable treatment has been found, although minoxidil may be efficacious in some patients. Minoxidil has generated new interest in hair-loss research. The etiology of hair loss must be better understood before more effective treatment regimens can be designed.
Androgenetic alopecia is the most common type of hair loss in men and women. The disorder represents a quantitative phenotype with an underlying genetic disposition. So far none of the causative genes have been identified. Under the influence of androgens there is a shortening of the anagen phase as well as a reduction of the cellular hair matrix volume in the involved scalp area. This results in the transformation of thick terminal hair follicles into thin vellus-like hair follicles. Clinically, patients present with an alopecia that follows a defined pattern (pattern baldness) and progresses continuously but in varying degrees. In advanced cases, men may develop baldness with remaining hair exclusively in the temporal and occipital regions. Women are prone to exhibit a more diffuse type of hair loss with pronounced thinning in the parietal region. Whereas the diagnosis of androgenetic alopecia is easy, its treatment is often difficult. The physician is commonly confronted with high patients' expectations regarding hair regrowth. Today, with minoxidil and finasteride, effective therapies are available which can lead to cessation of hair loss. The identification of underlying genes will make a more specific therapy easier to achieve.
Skin laxity, rhytides, and photoaging are generally treated by ablative procedures that injure or destroy the epidermis and its basement membrane, at least in the beginning, and subsequently lead to fibrosis of the papillary dermis. The ideal treatment would be to preserve the epidermis and promote normal collagen and elastin formation in the dermis. Percutaneous collagen induction takes us closer to this ideal.
The authors performed a retrospective analysis of 480 patients in South Africa and Germany with fine wrinkles, lax skin, scarring, and stretch marks treated with percutaneous collagen induction using the Medical Roll-CIT to produce tighter, smoother skin. Most patients had only one treatment, but some have had as many as four treatments. Patients were prepared with topical vitamin A and C cosmetic creams for a minimum of 4 weeks preoperatively.
On average, patients in Germany rated their improvement between 60 and 80 percent better than before the treatment. Histologic examination was carried out in 20 patients and showed a considerable increase in collagen and elastin deposition at 6 months postoperatively. The epidermis demonstrated 40 percent thickening of stratum spinosum and normal rete ridges at 1 year postoperatively.
Percutaneous collagen induction was started in 1997 and has proved to be a simple and fast method for safely treating wrinkles and scars. As opposed to ablative laser treatments, the epidermis remains intact and is not damaged. For this reason, the procedure can be repeated safely and is also suited to regions where laser treatments and deep peels cannot be performed.
The success of transdermal drug delivery has been severely limited by the inability of most drugs to enter the skin at therapeutically useful rates. Recently, the use of micron-scale needles in increasing skin permeability has been proposed and shown to dramatically increase transdermal delivery, especially for macromolecules. Using the tools of the microelectronics industry, microneedles have been fabricated with a range of sizes, shapes and materials. Most drug delivery studies have emphasized solid microneedles, which have been shown to increase skin permeability to a broad range of molecules and nanoparticles in vitro. In vivo studies have demonstrated delivery of oligonucleotides, reduction of blood glucose level by insulin, and induction of immune responses from protein and DNA vaccines. For these studies, needle arrays have been used to pierce holes into skin to increase transport by diffusion or iontophoresis or as drug carriers that release drug into the skin from a microneedle surface coating. Hollow microneedles have also been developed and shown to microinject insulin to diabetic rats. To address practical applications of microneedles, the ratio of microneedle fracture force to skin insertion force (i.e. margin of safety) was found to be optimal for needles with small tip radius and large wall thickness. Microneedles inserted into the skin of human subjects were reported as painless. Together, these results suggest that microneedles represent a promising technology to deliver therapeutic compounds into the skin for a range of possible applications.
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