Hair Loss

Khaitan BK, et al Indian J Dermatol Venereol Leprol 2004;70:350

….Nine patients had alopecia universalis and one had alopecia totalis. The earliest regrowth of hair on the scalp was seen at 1 month. Cosmetically acceptable hair regrowth was seen at 2-8 months. This meant that the regrowth covered cosmetically important areas like scalp, eyebrows and in male patients, moustache and beard, showing terminal hair on >75% of the affected area. The dose of betamethasone was tapered step-wise by 1 mg per dose every month once cosmetically acceptable regrowth was achieved. The eyebrows and eyelashes began to respond in 1-4 months (mean 2 months). Hair growth over the extremities started in about 3-4 months.

At the end of 6 months, 7 patients (43.7%) showed an excellent response [Figure - 1], [Figure - 2] after which the dose of betamethasone was tapered step-wise and finally stopped. In the subsequent follow-up (5 to 8 months) there was a relapse in 1 patient after 2 months of stoppage of treatment and OMP had to be restarted. Another patient showed scanty re-growth of hair on the eyebrows. Five (31.2%) patients showed a good response after 6 months of therapy [Figure - 3], [Figure - 4]. Betamethasone was continued in these patients in the same doses (5 mg) for another 2 months and then gradually tapered and finally stopped. There has been no relapse in this group of patients. Two (12.5%) patients showed an unsatisfactory response at the end of 6 months. The dosage was tapered in next two months to 3 mg of betamethasone and was continued till one year and then tapered off in the next 3 months. Further improvement was not significant. The remaining two (12.5%) patients were non-responders and both had alopecia universalis. In one of them there was growth of a few vellus hair.

The best treatment response was seen on the scalp. The extremities and eyebrows still showed a few remaining areas of hair loss and required further topical treatment with corticosteroids with variable response. The side effects noted were cushingoid facies and weight gain in 2 patients and acneiform eruption in 2 patients. Three patients complained of mild gastric discomfort which responded to antacids and H2 blockers. At present there are 12 patients who are off treatment since 5 to 8 months and there has been no relapse.

Dermatologica. 1987;175:19

Hair follicle biology and topical minoxidil: possible mechanisms of action.
Headington JT.

How minoxidil stimulates hair regrowth remains undetermined. ..snip…. Possible sites of direct drug action include either the dermal papilla of the follicle or hair matrix cells. Morphometric studies of control scalp biopsies taken from young male patients with androgenetic alopecia (male pattern hair loss) reveal that the primary morphologic event is miniaturization of terminal hair follicles…accompanied by shortening of the hair growth cycle ..snip…There has been no suggestion in any morphologic studies of minoxidil-treated patients for development of new follicles (f. Because dermal papilla of the hair follicle apparently controls both growth and differentiation of hair matrix cells ….snip…,

edited for hair loss treatment blog use

Br J Dermatol. 1978;99(4):371

The long term effect of repeated pluckings on the function of the mouse vibrissal hair follicles.
Ibrahim L, Wright EA.

Single mouse vibrissae were plucked repeatedly at the same time of the cycle (10–15 days after eruption) for ten successive hair regrowth cycles from eight individual follicles. After three hair pluckings the first grey whisker appeared, after six pluckings all were grey. Two follicles stopped producing whiskers after seven pluckings and another two after the 8th. Henceforth only 50% of the follicles continued producing whiskers until the end of the experiment. All the follicles which ceased to produce whiskers had a keratogenous cyst occupying most of the hair follicle in direct contact with the dermal papilla. In all cases the isolated dermal papilla was condensed and rounded in shape. Both loss of pigment and cyst formation could be due to the mechanical damage in the hair follicle caused by repeated plucking.

Hair Loss Treatment at the Proctor clinic

Arch Dermatol Res. 1978;263:297-306.

The histodynamic of alopecia areata in the dependence on the griseofulvin-induced epithelial proliferation

Franz E.

The histodynamic of hair loss due to alopecia areata–without or with the medicamentous induction of the hair regrowth respectively–was investigated comparatively. 1. Griseofulvin induced an epithelial proliferation in alopecia areata associated hair loss, which is noticeable in the surface epithelium as well as in the follicular epithelium. 2. Under the influence of griseofulvin a deeper penetration of the follicles into the fatty tissue–in connexion with a cutan-subcutaneous volume increase–results; at the same time the supra- and infraseboglandular follicular areas are lengthened. snip…..