Hair and Scalp Treatments A Practical Guide: A Practical Guide
Abstract
Conditions of the hair and scalp can be genetic or the result of infection, hormone imbalance, medication, trauma, or underlying primary disease. Regardless, they often cause significant psychological distress and sometimes physical discomfort, though much can be done to treat these complaints. Hair and Scalp Treatments focuses on therapy of hair and scalp disorders and includes chapters on procedures that are commonly used, as well as chapters on each specific disorders. Each chapter briefly describes the disease or the procedure to the reader and then teaches the step-by-step treatment algorithm or the way to perform the procedure.
This book also discusses several topics that patients seeking treatment for hair disorders ask the physician, such as how to choose proper shampoo and conditioner, hair dyes, nutritional supplements, and future treatments with regenerative medicine. Hair and Scalp Treatments is the only book of its kind focused on treatment and addresses topics that are not covered by current titles on hair disorders. Written and edited by leading experts in the field, this practical guide can be used not only by dermatologists but by general practice and family physicians as well.
... С учетом отсутствия доказательной базы в отношении эффективности лечения УФБ 311 нм при ГА, этот способ не входит в перечень основных методов терапии. Основываясь на результатах изучения данных о применении УФБ 311 нм, можно сделать вывод, что средневолновая узкополосная фототерапия более эффективна при ограниченных формах ГА и ее следует рассматривать как дополнительный метод в сочетании с другими терапевтическими опциями [26,27]. Например, показано, что лазерные методики и фототерапия в сочетании с миноксидилом являются безопасными и оказывают хороший эффект, проявляющийся не только более интенсивным отрастанием волос, но и уменьшением количества рецидивов [28]. ...
Introduction . Atopic dermatitis (AD) is among a comorbid conditions in alopecia areata (AA), that influence the risk of development, severity of AA and the immunologic profile of the perifollicular inflammatory process. Narrowband UVB-311 nm, which has been successfully used in AD, is considered as a treatment for AA with limited efficacy, but may contribute to AA regression when combined with other therapies. The anti-inflammatory effect combined with the relative safety make it relevant to study the possibility of using this method in the treatment of AA in children.
Aim . To evaluate the efficacy of NB-UVB 311 nm in the complex therapy of pediatric patients with coexisting diseases: AA and AD.
Materials and methods . We conducted an open cohort comparative study with 49 patients 5–12 years old (mean age 7.4 ± 0.38 y.o.) with different clinical forms of AA. Group 1 included 22 patients with concomitant AD, group 2 consisted of 27 patients without AD. All patients received standard therapy of AA with topical glucocorticosteroids; patients of the first group also received a course of total NB-UVB 311 nm for the treatment of AD. The response to treatment was evaluated after 3 months and was considered as positive when hair regrowth was more than 30%.
Results . In group 1 there was a significant predominance of patients who responded to treatment (77%) compared to group 2 – 48% (OR 3.7; CI [1.05;12.8] p = 0.045); the mean percentage value of SALT index in group 1 decreased by 46% from baseline values, in group 2 – by 26.6%; when comparing the groups by the percentage of alopecia regression p = 0.027.
Conclusions . Combined treatment of AA including NB-UVB 311 nm, contributes to the tendency to more intensive hair regrowth. NB-UVB 311 nm can be considered as an additional option in the treatment of AA, associated with AD.
This article refers to the issues of alopecia and acne pathogenesis: anatomy of hair and sebaceous glands, biological factors affecting the stages of hair development and function of sebaceous glands. Alopecia is divided into two large groups: scaring and non-scaring alopecia, the later is represented by alopecia areata, telogen effluvium, and female pattern hair loss/androgenetic alopecia (FPHL/AGA). Before starting the search for systemic causes it is necessary to predetermine the type of alopecia on the basis of medical history and external manifestations. FPHL /AGA as a most common form of alopecia can often coexist with another common pathology – telogen effluvium, this fact determines therapeutic approaches and their results.
Main pathogenetic mechanisms, approaches to differential diagnostics and treatment of the main specified types of non-scarring alopecia are reviewed. FPHL/AGA is a main type of alopecia which is often referred to gynecologists/endocrinologists. It is now regarded a multifactorial pathology with the involvement of a genetic component, androgen receptor gene expression, dihydrotestosterone synthesis and local low grade inflammation specifics. FPHL/AGA can be with and without hyperandrogenism, in both cases it can be accompanied by an increased risk of metabolic syndrome. In case of FPHL/AGA with hyperandrogenism the success of treatment depends on the consistent coordinated work of gynecologist/endocrinologist and dermatologist/trichologist, which allows combining systemic and local therapy in a timely manner.
Also contemporary views on the acne pathogenesis are reviewed. Given the complex nature of acne its therapy is also complex and stepwise. According to current clinical guidelines and recent studies of the microbial component of acne pathogenesis the following conclusions are formulated. Patients with acne require assessment of androgen status, determination of the hyperandrogenism source, including evaluation of tissue androgens; phenotype of the syndrome and cardio-metabolic risks should be determined in patients with polycystic ovary syndrome; it is advisable to determine antimicrobial susceptibility of pathogens isolated from the inflamed pilosebaceous unit if acne form requires the local or systemic antibacterial therapy.
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