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Herbal medicines as an effective therapy in hair loss - A review

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Abstract

Though hair loss (alopecia) is not a debilitating or life threatening sickness, the very thought of becoming bald can lead to emotional stress and traumatic experience for those who suffer from premature or excessive hair loss. Many will try anything and everything to bring back their locks. Or at least, some of their once full head of hair. Hair loss sufferers spend billion of dollar annually on remedies ranging from drugs, vitamins to special tonics and shampoos. Conventional treatments of hair thinning includes drugs therapy and hair transplant. Minoxidil and Propecia (Finasteride) are the only two drugs approved by the FDA for hair growth in men. Minoxidil is the only drug available for women with androgenetic alopecia. These drugs have been proven to show positive results for balding conditions on the vertex region of the scalp. Though these drugs are effective, many are wary of their unknown long-term effect and potential side-effects. This has led to increase interest in alternative remedies such as herbal medicine.

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... Even though synthetic forms are comfortable amid daily use, they can be the cause of accumulated toxicity in the body amid long term use, for example, statin 1, 2 and finasteride, a 5-α reductase inhibitor 3 . There are many well-known phytochemical substances which have long been used as treatments for diseases [4][5][6] . Statin can be replaced with β-sitosterol in the treatment of high blood cholesterol 7 , which is a phytosterol synthesized only in plants for instance, Polygonum multiflorum 8 , Pygeum africanum 4 , Serenoa repens 4 , Gingko biloba 4 , Viola odorata 9 and Cissus repens 10 . ...
... There are many well-known phytochemical substances which have long been used as treatments for diseases [4][5][6] . Statin can be replaced with β-sitosterol in the treatment of high blood cholesterol 7 , which is a phytosterol synthesized only in plants for instance, Polygonum multiflorum 8 , Pygeum africanum 4 , Serenoa repens 4 , Gingko biloba 4 , Viola odorata 9 and Cissus repens 10 . Good health is supported by complete foods, es-sential phytochemicals (especially from plants as foods), vegetables, fruits and others for body mechanisms. ...
... There are many well-known phytochemical substances which have long been used as treatments for diseases [4][5][6] . Statin can be replaced with β-sitosterol in the treatment of high blood cholesterol 7 , which is a phytosterol synthesized only in plants for instance, Polygonum multiflorum 8 , Pygeum africanum 4 , Serenoa repens 4 , Gingko biloba 4 , Viola odorata 9 and Cissus repens 10 . Good health is supported by complete foods, es-sential phytochemicals (especially from plants as foods), vegetables, fruits and others for body mechanisms. ...
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Leaves of three Artocarpus species were hexane and ethanol extracted and chemically analysed. Cytotoxicity and genotoxicity tests were performed on peripheral blood mononuclear cells. The main phytochemical in the hexane extracts was (Z)-9-octadecenamide (oleamide). The ethanol extracts showed 21% 9,19-cyclolanost-24-en-3-ol in A. altilis, 19% n-hexadecanoic acid in A. heterophyllus, and 21% arbutin in A. lacucha. The hexane extract of A. altilis gave an IC50 of 0.00035 mg/ml but no IC50 values for A. heterophyllus and A. lacucha extracts. Ethanol extracts of A. altilis and A. lacucha had IC50 values of 0.868 and 0.218 mg/ml, respectively, but none for A. heterophyllus. All the hexane extracts showed non-significant DNA damage, while all the ethanol extracts significantly induced DNA damage (p < 0.05). A. lacucha leaf is newly reported as an alternative source of arbutin. © 2018 Science Society of Thailand under Royal Patronage.All right reserved.
... TE is the most common diffuse hair loss in women of reproductive age, which is due to concomitant somatic pathology (disorders and diseases of the gastrointestinal tract and the endocrine system, infectious diseases, etc.) and/or negative exogenous factors (inappropriate nutrition, drug intoxication, stress, inappropriate hair care, etc.) (Shrivastava, 2009). Hair follicles (HF) affected by harmful factors are characterized with anagen (active growth) termination, which results in the onset of catagen (hair involution) and subsequently 2-3 months telogen (resting phase) finishing with exogen -dead hair shedding (Figure 1) (Harrison and Bergfeld, 2009). ...
... In the TE therapy plants remedies occupy the important place (Patil et al., 2010;Kaushik et al., 2011). Plant biologically active substances (BAS) with vasodilation, capillary protective, epithelial cells regenerating effects, microelements, amino acids, vitamins and other nutrients for HF tissues saturation are widely used (Lourith and Kanlayavattanakul, 2013;Semwal et al., 2015). ...
... The listed BAS enhance blood circulation in the skin capillary system, stimulate the metabolism and trophic processes, exhibit regenerative properties of HF cells, therefore the remedies with stinging nettle (infusions, tinctures, lotions, masks, juices, etc.) are used for the TE prevention and treatment (Gülçin et al., 2004;Bhuwan et al., 2014;Mal Ait Haj Said et al., 2015). (Harrison and Bergfeld, 2009;medical illustrator: William Garriott). 1,2 -anagen phase (active hair growth, 2-8 years), 3,4 -catagen phase (involution, 4-6 weeks), 5 -telogen phase (resting, 2-3 months), 6 -exogen phase (release of dead hair), 7 -telogen effluvium (anagen termination, noticeable increase in hair shedding occurs 2 to 3 months after hair was affected). ...
Article
Telogen effluvium remains the most common diffuse hair loss in women which influences the quality of their life. Stinginag nettle leaves and stems contain a wide range of biologically active substances which stimulate the metabolism and trophic processes in hair follicle cells. The purpose of the research was to study the vasodilating effect and follicle-stimulating activity of the gel with nettle juice in rats under conditions of wool shedding induced by orally administered boric acid. Thus, conducted pharmacological studies indicated that the gel in comparison with the untreated animals accelerated the wool growth in rats, improved its quality by increasing the weight and reducing the percentage of dystrophic hairs. Histological studies confirmed that cutaneous application of the gel significantly dilated the vessels in the dermis reticular layer. The intensification of blood supply was confirmed by an increase in the number of mast cells and their active degranulation. Strengthening of blood circulation caused the increase of the hair follicle quantity in the active anagen phase.
... A study conducted at Chosun University College of Medicine in Korea discovered that the green tea antioxidant EGCG can protect human retina against UV damage.They concluded that the administration of EGCG increased the cell count and the cell activity after UV irradiation in cultured human retinal pigment epithelial cells [110] . Positive factors in hair growth and follicle health was observed for green tea recently by Patil SM [111] . They act through inhibition of apoptosis (programmed cell death),radioprotection of follicle cells,profound antioxidant activity and potential follicular inhibition of TGF beta [112] . ...
... A high intake of green tea causes higher levels of sex hormone binding protein globulin which carries hormones like testosterone around the body in a bound unusable form so that tissuses cannot use it direcly.Testosterone is usually carried around the body by this binding protein,therefore reducing levels of free testosterone,so that it cannot be converted to dihydrotestosterone in the hair follicle,which is thought to shorten the hair cycle and causes hair loss in men. Green tea is thought to affect the 5a-reductase type 1 enzyme,which converts testosterone to dihydro testosterone [111] . ...
... So far, the benefit of green tea is known only to the body. But, green tea polyphenols are only recently understood as positive factors in hair growth and follicle health 60 . They possess some of the mechanisms of action as including inhibition of apoptosis (programmed cell death), radioprotection of follicle cells, profound antioxidant activity, and potential follicular inhibition of TGF-beta 61 . ...
... Testosterone is usually carried around the body by this binding protein, therefore, reducing levels of free testosterone, so that it cannot be converted to dihydrotestosterone (DHT) in the hair follicle, which is thought to shorten the hair cycle and cause hair loss in men. Green tea is thought to affect the 5α-reductase type I enzyme, which converts testosterone to DHT 60 . Although these findings are at preliminary stage these studies suggest that further analysis in this regards can prove to promising in future. ...
... Excess androgens production such as dihydrotestosterone, iron deficiency anaemia, stress, protein energy malnutrition, nervous disorders, aging, hormonal imbalance and exposure to radiations are the confounding factors contributing to hair loss. [4] Minoxidil a potent vasodilator is used for treatment of alopecia. As synthetic drugs are linked with side effects minoxidil usage is limited besides its pharmacological benefits. ...
... As an animal food, stinging nettle leaves are important for increase and improve of body weight and meat quality [Hanczakowska, Wiytkiewicz, & Szewczyk, 2007] [Khosravi, et al, 2008] [Kwiecien, & Mieczan, 2009]. Stinging nettle leaf extract is used in the manufacture of personal care products and pharmaceutical products, like shampoos, toothpaste and creams with certain functionality [Rayburn, et al, 2009] [Patil, Sapkale, & Surwase, 2010]. The potential of the stinging nettle fi bres in the production of natural textiles is investigated, also [Vogl, & Hartl, 2003] [Fischer, Werwein, & Graupner, 2012]. ...
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Content of proteins and minerals (Mg, Ca, Cu, Zn, Mn and Co) in leaves, stem and root of stinging nettle collected from different localities from the Republic of Macedonia were determined. Generally, the higher content of proteins and minerals were determined in leaves, followed by the content in stem and root. In the quantity of proteins significant differences were determined depending to the organ of stinging nettle. The highest determined values for the protein content in leaves expressed to the dry mass were 26.89% in leaves, 14.54% in stem and 10.89% in root. The values for the calcium content in stinging nettle were higher in comparison to the magnesium values. Zink content in the leaves was two and fi ve times higher than the content of copper and manganese, respectively. In leaves, stem and root non signifi cant differences in cobalt content were determined.
... Polygonum multiflorum, He-Shou-Wu in Chinese, is one of the most commonly used traditional Chinese medicines (TCMs) and functional foods for tonic and anti-aging effects in China and officially listed in Chinese Pharmacopeia [1,2]. Different types of P. multiflorum preparations are popular around the world recent years for preventing hair loss and premature graying. ...
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It was shown that different extracts had significant differences in the toxicity of Polygonum multiflorum. In this study, the effect of sample preparation on components and liver toxicity of different extracts from P. multiflorum were determined. Hepatoxic components were discovered based on biomembrane extraction. Comparative chemistry and toxicology between ethanol and water extracts were also performed. The results showed that ethanol extract had much stronger hepatotoxicity, the content of emodin-8-O-β-d-glucopyranoside, physcion-8-O-β-d-glucopyranoside, emodin and physcion was significantly higher in ethanol extract than in water extract, while the human hepatocytes extraction showed that 2,3,5,4'-tetrahydroxystilbene-2-O-β-d-glucopyranoside, emodin-8-O-β-d-glucopyranoside, physcion-8-O-β-d-glucopyranoside, emodin and physcion had interaction with human hepatocytes. The hepatotoxic effect of these components was investigated on human hepatocytes LO2 cells and emodin-8-O-β-d-glucopyranoside, physcion-8-O-β-d-glucopyranoside, emodin and physcion were finally confirmed to be, at least partial, hepatotoxic components. The results showed that sample preparation has significant effect on components in extracts of P. multiflorum especially the components related to hepatotoxicity. Water extract, the conventional administration form of Chinese herbs, is prefer for phytotherapy before well understanding their chemistry and biological activities. Copyright © 2015 Elsevier B.V. All rights reserved.
... For example, minoxidil which is used topically on the scalp usually causes itching on the scalp, irritation, and allergies [1]. The examples of herbal plants that have hair growth activities are algae extract, ginkgo biloba, the green, saw palmetto, stinging nettle [2] as well as Angiopteris evecta) [3] and Sauropus androgynous [4]. ...
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Objective: Previous research has proven that the water fraction of the Angiopteris evecta root has hair growth activities. The objective of this research was to determine the formula of gel and hair tonic preparations of pakis munding (Angiopteris evecta L.) which met the requirements as a pharmaceutical preparation, good and effective in stimulating hair growth. Methods: Formulation of hair tonic and gel preparations were made using 7.5, 10.0, and 12.5 % of A. Evecta root water extracts as active compounds. The formulation of the two preparations was based on the standard formulation method. The evaluation and formulation test were carried out by organoleptic examination and homogeneity, pH, viscosity, scattering power test, stability test, and safety test based on the standard preparations including Indonesian pharmacopeia. Statistical tests were carried out on both formulas against rabbits based on the modification of the Tanaka method. Comparison of statistics on both formulas was also carried out. Results: It was found both formulas fulfill standard requirements as pharmaceutical preparations. Statistically, the best activity in hair tonic preparations was at a concentration of 12.5% and for gels at a concentration of 10.0% ethanol extract seen from measurements of hair length. Statistically, using the Independent T-test to find out the significant differences in the average hair length on hair tonic and gel, it was found there was no significant difference between the two formulas. It was found that the best formula for hair tonic and gel was in the addition of 10.0% and 12.5% extracts, respectively. Conclusion: The results obtained in this research work clearly indicated that both hair tonic and gel formulas of A. evecta root water extract may be used as stimulating hair growth.
... Many of these causes are temporary and a few are permanent. These are some of the more common reason for hair loss [2]. ...
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Hippocrates first used the term alopecia, the characteristics of the hair fall disease we know to be alopecia were first described by cornelius celsus in 30 A.D. Hair loss is the thinning of hair on the scalp. The medical term for hair loss is alopecia. Alopcia areata (AA) is a non-scarring autoimmune hair loss on the scalp/body. Causes like Emotional strains, stresses and nervous disorders Aging, Infections, Hormonal imbalance etc. Genetic predisposition, autoimmunity, and environmental factors play a major role in the etiopathogenesis of AA. The most common site affected is the scalp in the form of single or multiple patches of alopecia. Histopathology is characterized by an increased number of telogen follicles and presence of inflammatory lymphocytic infiltrate in the peribulbar region. This article explains outline of etiologic and pathogenic mechanism, clinical features, diagnosis and management of alopecia.
... [13] Overall Triphala is also tridoshahar. Neelibhringadi Taila is a precious formulation of Ayurveda and is highly regarded for the following characteristics: [14] [15] [16] • Antimicrobial and Antibacterial (Useful in all scalp infections) ...
... Anti-hair fall 41 By inhibition of apoptosis, radioprotection of follicle cells, profound anti-oxidant activity and potential follicular inhibition of TGF-beta. ...
Article
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Green tea (Camellia sinensis) always influenced human health benefits associated with this herbal drink. Green tea has possible benefits include promotion of cardio-vascular health, cancer prevention, skin protection, and antioxidant activity, to fight high cholesterol levels, infection, impaired immune system, diarrhoea, fatigue and much more. The credit for their useful antioxidant property exists with their huge collection of chemical substances called polyphenols and catechins make the major contribution to them. In addition, its content of certain minerals and vitamins increases the antioxidant potential of this type of tea The present paper reviews the geographical distribution, history, cultivation, uses, side effects, synonyms, botanical description, taxonomical classification, phytochemical constituents and pharmacological activities.
... It's a green plant with stinging hairs on both faces of its leafs. The presence of valuable compounds such as: phenolic and flavonoid components [1,2], contributes to the utilization of stinging nettle as an important medicinal herb in the human diet [3,4,5,6,7]. ...
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To assess the effects of contamination induced by traffic at the vicinity of a highway (R7, Kosovo), the study were carried out on two sites with different profiles and traffic intensity. Pollutants generated by traffic at the vicinity of a highway have been contaminating plants that grow in area impacted by airborne pollution with high metal contents. Urtica dioica L is popularly consumed as tea, and is widely developed in the whole country. This study aims to investigate the chemical profile (biomarker of exposure), and antioxidants potential of extracts of Urtica dioica L collected from an exposed area by pollutants from R7 highway (Kosovo) and other comparison group (the rural area of Prizren, environment without pollution). The ICP OM (AA) analyses indicated the difference of the toxic elements levels at the exposed area compared from control group. The presence of antioxidants such as total phenols, total flavonoids and FRAP was statistically superior in the extract of Urtica dioica L in exposed area. The results indicated that the metal bioaccumulation markedly influenced the antioxidant capacity of analyzed plant samples.
... Dihydrotestosterone (DHT) further reduces the life cycle of hair follicles which leads to hair loss and baldness. Green tea has potential to inhibit 5α-reductase enzyme and also stimulates sex hormone-binding protein globulin (SBGH) which remains the testosterone in bound form so that it cannot change into dihydrotestosterone (DHT) (Patil et al., 2010). ...
... Topical application of biological response modifiers and antiandrogens are currently available therapies for the management of telogen effluvium; however, the low success rate and associated adverse effects limit their clinical use. Many researchers proved that various herbal materials helped to prevent the hair fall disorders [7][8][9][10]. Among the various materials Cereus grandiflorus (cactus) Flower extract very much pronounced with respect to hair fall control. ...
... Green tea is rich in the flavanol group of polyphenols called catechins, and green tea polyphenols positively affect hair growth and follicle health. Possible mechanisms of action include inhibition of apoptosis, radioprotection of follicle cells, antioxidant activity, and potential follicular inhibition of TGF-1 [38]. Green tea is a popular herbal remedy that contains catechins that may inhibit 5 -reductase. ...
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The proprietary DA-5512 formulation comprises six herbal extracts from traditional oriental plants historically associated with therapeutic and other applications related to hair. Here, we investigated the effects of DA-5512 on the proliferation of human dermal papilla cells (hDPCs) in vitro and on hair growth in C57BL/6 mice and conducted a clinical study to evaluate the efficacy and safety of DA-5512. DA-5512 significantly enhanced the viability of hDPCs in a dose-dependent manner ( p<0.05 ), and 100 ppm of DA-5512 and 1 μ M minoxidil (MXD) significantly increased the number of Ki-67-positive cells, compared with the control group ( p<0.05 ). MXD (3%) and DA-5512 (1%, 5%) significantly stimulated hair growth and increased the number and length of hair follicles (HFs) versus the controls (each p<0.05 ). The groups treated with DA-5512 exhibited hair growth comparable to that induced by MXD. In clinical study, we detected a statistically significant increase in the efficacy of DA-5512 after 16 weeks compared with the groups treated with placebo or 3% MXD ( p<0.05 ). In conclusion, DA-5512 might promote hair growth and enhance hair health and can therefore be considered an effective option for treating hair loss.
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I designed and formulated a shampoo containing the alcoholic extract of Urtica urens L. using an analytical, experimental and comparative method. white rabbits, New Zealand breed males (irritation test for biological evaluation of medical devices) were used. They were part of this study diagnosed with hair loss non-pathological origin; numbering 10 people were evaluated by a medical professional, for 21 days. They were subjected to microscopic observation fallen hair daily to assess whether there is increased hair diameter compared to the beginning and end of the study. fallen hair count per day throughout the treatment was obtained. Using the method of standardized hair count by 60 seconds. They were obtained as results that the percentage of hair loss reduction was 56.8% for the group of people who used the shampoo at a concentration of 2% and 32.1% for the group of people using a shampoo 5% concentration. the average diameter of fallen hair count and evaluation of fallen hairs per day were compared, using the hair counting method standardized for 60 seconds. It was able to design and make a shampoo containing alcoholic extract of Urtica urens L.; showing its effectiveness in treating hair loss achieving greater than 50% improvement and determined not produce skin irritability.
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The aim of the work. Technology development of "Stimuphyt" complex tincture which is intended for Telogen effluvium cutaneous treatment. Materials and Ьethods. As plant raw materials (PRM) a following mixture was used: Urtica dioica leaves –50 g, Salvia officinalis leaves –30 g, Aesculus hyppocastanum leaves –20 g. Optimal extraction parameters were being chosen for the technology development of the complex tincture, namely: the concentration of ethanol (20% 40%, 70%), the ratio of PRM and obtained tincture (1:5, 1:10, 1:15, 1:20), sizes of PRM particles (cut and non- sifted PRM, different fractions), time (6 h, 1 day, 2 days, 3 days, 7 days) and the extraction methods (maceration, remaceration, percolation). The yield of dry residues and quantitative content of hydroxycinnamic acids (GCA) were used as the evaluation criteria. Results and Discussion. 40 % ethanol was chosen as an extraction agent, because it dissolves the basic biologically active substances and is safe for cutaneous application. Taking into account the concentration of dry residues and GCA in the tincture and also in the dry PRM (recalculation of PRM extraction efficiency) the complex tincture technology was substantiated. Thus the tincture was obtained from cut and non- sifted mixture of PRM at a 1:10 ratio with the method of triple remaceration for 3 days. Conclusions. The optimum technological parameters of the complex tincture preparation were determined, namely: the concentration of ethanol – 40 %, the ratio of PRM and obtained product – 1:10, sizes of PRM particles – cut and non- sifted PRM, extraction time – not longer than 3 days, the method of extraction – remaceration. Considering the obtained results, the technological scheme of "Stimuphyt" complex tincture preparation in industrial conditions was developed.
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Green tea in its purest and most unadulterated form has always influenced human health from generations and day by day scientific evidences throughout the world are making people aware of health benefits associated with this herbal drink. Though Green Tea is not officially recognized as a medical agent, it is one of the most researched plant-based remedies whose possible benefits include promotion of cardio-vascular health, cancer prevention, skin protection, and antioxidant activity, to fight high cholesterol levels, infection, impaired immune function, diarrhoea, fatigue and many more. Laboratory findings have revealed that notable health benefit of green tea is its powerful antioxidants potential which at the molecular level, helps prevent cellular damage from certain oxidation reactions in the body. The credit for their useful antioxidant property lies with their huge collection of chemical substances called polyphenols and catechins make the major contribution of them. Though catechins have been found in other plants derivatives such as grapes, pomegranates, those found in tea have proven to be the most effective antioxidants known. The catechins epigallocatechin gallate (EGCG) is found in the greatest concentration and most studied for its health benefits. There is an urgent need to check the efficacy, safety and translational guidelines for a green tea to be used as safe, effective drug. The main objective of this review is to enlighten some recent facts with relevance to the current status and advance in green tea benefits.
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Hair formulation of Emblica officinalis (Euphorbiaceae), Bacopa, monnieri (Scrophulariaceae), Trigonella foenumgraecum (Leguminosae), Murraya koenigii (Rutaceae) in various concentrations in the form of herbal oil were studied for their hair growth activity. Each drug was tested for their hair growth activity in a concentration range for 1-10% separately. Based on these results mixture of crude drugs Murraya koeniigi , leaf (Rutaceae), Bacopa monnieri , leaf (Scrophulariaceae), Trigonella foenumgraecum (Leguminosae), Murraya koenigii (Rutaceae) were prepared in varying concentration in the form of herbal hair oil by three different oils preparation techniques and were tested for hair growth activity. The result revealed that the hair growth activity of each drug was found proportional to the concentration range tested. Similarly higher concentrations of drug in the formulation were found to have higher hair growth activities. But looking towards the formulation viscosity the maximum concentration of combined drug was found to be 30% at their maximum level. The formulation containing 7.5% of each drug used for the study and showed excellent hair growth activity with standard (2% minoxidil ethanolic solution) by an enlargement of follicular size and prolongation of the anagen phase. It holds the promise of potent herbal alternative for minoxidil. Excellent results of hair growth were seen in formulation prepared by cloth pouch decoction method of oils preparation technique.
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A mixture of petroleum ether extract of Eclipta alba Hassk. (compositae), Citrullus colocynthis Shrad. (cucurbitaceae) and Tridax procumbens Linn. (compositae) in various concentration in the form of Herbal Cream and Herbal oil were studied for their hair growth activity. The ratio of E.alba, C.colocynthis and T.procumbens in 3:1:2 showed excellent hair growth activity and they showed 35% more anagen hair follicles, while standard drug (2% Minoxidil ethanolic solution) showed 20% more anagen hair follicles, when compared to control. At the ratio 1:2:3 they showed comparable activity with the standard.
Here, we sketch why significant progress in the as yet very unsatisfactory pharmacological management of hair loss demands more rational strategies for ‘hair drug’ development, which effectively target defined key events in hair follicle cycling and transformation. Chiefly, drugs need to be identified that serve as inhibitors of catagen, exogen and/or the terminal-to-vellus transformation, or that induce anagen. For this, identification of the relevant molecular controls of human hair follicle cycling is an essential prerequisite.Section editor:Mike P. Philpott – Queen Mary School of Medicine and Dentistry, University of London, UK
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The rational evaluation of hair disorders requires familiarity with follicular anatomy. Hair structure can be easily examined by studying clipped hair shafts, entire hairs gently pulled or forcibly plucked from the scalp, and scalp biopsies (sectioned vertically or transversely). Anatomic features will be different depending on whether a given hair is in the anagen, catagen, or telogen phase. Follicle size will also vary, from the minute vellus hair to the long, thick terminal hair. Each follicle can be divided into distinct regions--bulb, suprabulbar zone, isthmus, and infundibulum. Activity growing (anagen) hairs are characterized by a hair matrix surrounding a dermal papilla; inner and outer root sheaths are present and well developed. A catagen hair can be identified by its markedly thickened vitreous layer and fibrous root sheath, which surrounds an epithelial column; above this column, the presumptive club forms. A telogen hair is distinguished by its fully keratinized club, which is surrounded by an epithelial sac. Below this lies the secondary hair germ and condensed dermal papilla, waiting for the mysterious signal that initiates a new life cycle.
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Evidence for the growth stimulatory properties of human keratinocyte-derived conditioned medium on human scalp dermal papilla cells and a mouse fibroblast cell line (Balb/c 3T3) is presented. There was no mitogenic effect on human keratinocytes. This conditioned medium induced a 2-5-fold increase in mitogenic activity in papilla cells relative to sham-conditioned medium as measured by 3H-thymidine incorporation. The papilla cell growth-stimulating activity of the conditioned medium was sensitive to heat, and from size exclusion the molecular weight was greater than 3000 Da.
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Alopecia areata is a common disorder usually diagnosed on the basis of history and physical findings alone. Although most patients have a good prognosis and can be successfully treated with available medications, treatment can be slow and emotionally difficult. Early recognition, intervention involving topical and/or intralesional therapy, and education can provide patients with comforting reassurance about eventual recovery.
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Although it is universally accepted that dihydrotestosterone causes baldness, how it does so is not well understood. I propose that 3 mechanisms are at work: miniaturization by a dihydrotestosterone-induced acceleration of the mitotic rate of the matrix that leaves less and less time for differentiation; an increased telogen shedding as a result of the shortening of the hair cycles that increases the telogen number per unit of time; and the increased number and duration of the lag phase or kenogen. That this last mechanism is related to dihydrotestosterone is unclear.