Exp Dermatol. 2008 Jul;17(7):630-1.

17-beta estradiol and prednisolone as potential stimulators of hair re-growth in
chemotherapy-induced human hair follicle damage via ‘dystrophic catagen’
promotion?

Bodó E, van Beek N, Naumann V, Ohnemus U, Brzoska T, Abels C, Paus R.

Department of Dermatology, University of Lübeck, Lübeck, Germany.

Chemotherapy-induced hair follicle (HF) damage and alopecia are common
side-effects of cancer therapy and constitute a major burden of disease in
clinical oncology. Although several potential treatment strategies have shown
promising effects in animal models, e.g. on cyclophosphamide-induced alopecia
(CIA) in C57BL/6 mice, these strategies remain to be transferred to human
therapy. 17-beta estradiol (E2) and glucocorticoids are potent modulators of
murine CIA in vivo: topical treatment accelerates the regrowth of normally
pigmented hair shafts by shifting HFs into the ‘dystrophic catagen’ pathway,
which is associated with greater initial alopecia, but much faster HF recovery.
In the current study, we asked whether E2 and/or prednisolon display similar
activities in the human system, using our recently established human HF dystrophy
in vitro-model (Bodó et al., Am J Pathol 2007: 171(14):1153-67). E2 and/or
prednisolon were pre- and co-administered with a key cyclophosphamide metabolite
(4-HC). Indeed, E2 shifted 4-HC-treated human HFs into the dystrophic catagen
pathway in vitro, and potentiated the 4-HC-induced pigmentary disturbances.
4-HC-induced hair growth inhibition was further enhanced by E2, associated with
an additional reduction of proliferation and increased apoptosis of matrix
keratinocytes. These effects tended to be further enhanced by co-administration
of prednisolon to the HF organ culture medium. These observations suggest that,
just as in murine CIA in vivo, E2 and glucocorticoids can force
chemotherapy-damaged human HFs into the dystrophic catagen pathway. The
preclinical data provide first indications that a combination of E2 with
prednisolone may indeed serve as an effective clinical tool for accelerating hair
re-growth in human CIA.

PMID: 18559008 [PubMed - in process]

Related Links

Topical estrogen accelerates hair regrowth in mice after chemotherapy-induced
alopecia by favoring the dystrophic catagen response pathway to damage. [J Invest
Dermatol. 2004] PMID:14962083

Dissecting the impact of chemotherapy on the human hair follicle: a pragmatic in
vitro assay for studying the pathogenesis and potential management of hair
follicle dystrophy. [Am J Pathol. 2007] PMID:17823286

Zinc as an ambivalent but potent modulator of murine hair growth in vivo-
preliminary observations. [Exp Dermatol. 2005] PMID:16232307

A new strategy for modulating chemotherapy-induced alopecia, using PTH/PTHrP
receptor agonist and antagonist. [J Invest Dermatol. 2001] PMID:11511291

Hair growth modulation by topical immunophilin ligands: induction of anagen,
inhibition of massive catagen development, and relative protection from
chemotherapy-induced alopecia. [Am J Pathol. 1997] PMID:9094998

Biol Pharm Bull. 2008 Mar;31(3):449-53.

trans-3,4′-Dimethyl-3-hydroxyflavanone, a hair growth enhancing active component,
decreases active transforming growth factor beta2 (TGF-beta2) through control of
urokinase-type plasminogen activator (uPA) on the surface of keratinocytes.

Sasajima M, Moriwaki S, Hotta M, Kitahara T, Takema Y.

Global R&amp, Biological Science, Kao Corporation, 2606 Akabane, Ichikaimachi,
Haga, Tochigi 321-3497, Japan. sasajima.michiyo@kao.co.jp

trans-3,4′-Dimethyl-3-hydroxyflavanone (t-flavanone) is a synthetic compound with
hair growth enhancing activity that is effective against male pattern alopecia.
t-Flavanone was designed as a derivative of astilbin, the active hair growth
enhancing component of Hypericum perforatum extracts. This study was designed to
elucidate the mechanism of hair growth enhancement by t-flavanone. We
investigated the effects of t-flavanone on transforming growth factor beta
(TGF-beta), a known catagen-inducing factor induced in hair papilla cells by male
hormone. When t-flavanone was added to cocultures of human hair papilla cells and
human keratinocytes, there was no change in the total level of TGF-beta2.
However, levels of active TGF-beta2 were reduced, suggesting the involvement of
t-flavanone in the activation pathway of TGF-beta2. In order to investigate the
effects of t-flavanone on TGF-beta2 activation by human keratinocytes, we
evaluated the level of active TGF-beta2 converted from the inactive form in
t-flavanone-treated human keratinocytes. The amount of active TGF-beta2 was
reduced compared with controls suggesting that t-flavanone suppresses the
TGF-beta2 activation cascade in human keratinocytes. We then examined the
activity of urokinase-type plasminogen activator (uPA), the rate-limiting enzyme
in the TGF-beta2 activation cascade, in t-flavanone-treated human keratinocytes.
We found that t-flavanone reduces uPA activity on the keratinocyte surface.
t-Flavanone is a hair growth enhancing component that has a novel mechanism of
action which suppresses TGF-beta2 activation, and thereby is expected to have
therapeutic effects on other types of alopecia in addition to male pattern
alopecia.

PMID: 18310908 [PubMed - indexed for MEDLINE]

Related Links

Towards dissecting the pathogenesis of retinoid-induced hair loss: all-trans
retinoic acid induces premature hair follicle regression (catagen) by
upregulation of transforming growth factor-beta2 in the dermal papilla. [J Invest
Dermatol. 2005] PMID:15955085

Role of TGF-beta2 in the human hair cycle. [J Dermatol Sci. 2004] PMID:15194142

Androgen-inducible TGF-beta1 from balding dermal papilla cells inhibits
epithelial cell growth: a clue to understand paradoxical effects of androgen on
human hair growth. [FASEB J. 2002] PMID:12397096

L-carnitine-L-tartrate promotes human hair growth in vitro. [Exp Dermatol. 2007]
PMID:17927577

Enhanced production of plasminogen activator activity in human and murine
keratinocytes by transforming growth factor-beta 1. [J Invest Dermatol. 1992]
PMID:1629632

Dermatol Ther. 2008 Jan-Feb;21(1):13-21.

Trichotillomania.

Sah DE, Koo J, Price VH.

Department of Dermatology, University of Calfornia, San Francisco, California
94143, USA.

Patients with trichotillomania often first present to dermatologists, as patients
may be unaware of or deny hair pulling and seek an etiology for their hair loss.
It therefore becomes the job of the dermatologist to correctly diagnose
trichotillomania as well as offer treatment options. There appear to be three
groups characterized by age of onset: preschool-age children, preadolescents to
young adults, and adults. Young children often have a self-limited course of hair
pulling. Adults frequently have psychiatric conditions associated with their
trichotillomania. Preadolescents to young adults may benefit the most from active
intervention, such as increasing awareness of hair pulling behaviors and behavior
modification training. The approach of a patient by age of onset is helpful in
guiding a dermatologist towards effective treatment options.

PMID: 18318881 [PubMed - indexed for MEDLINE]

Related Links

Diagnosis and management of trichotillomania in children and adolescents.
[Paediatr Drugs. 2005] PMID:16356024

[Trichotillomania: three cases presentation and diagnosis tests review] [Invest
Clin. 2007] PMID:17853795

Trichotillomania and self-esteem: a survey of 62 female hair pullers. [J Clin
Psychiatry. 1996] PMID:8591973

Under-diagnosed psychiatric syndrome. I: Trichotillomania. [Ann Acad Med
Singapore. 1999] PMID:10497682

Trichotillomania. Presentation, etiology, diagnosis and therapy. [Am J Clin
Dermatol. 2001] PMID:11721651

Br J Nurs. 2008 Feb 14-27;17(3):192-7.

Idiopathic hirsutism: excessive bodily and facial hair in women.

Elghblawi E.

Department of Dermatology, Bir Usta Hospital, Tajoura, Libya.

Hirsutism is the excessive and increased bodily and facial hair growth in women
in locations where hair is normally minimal or absent. It refers to the growth of
hair in a pattern normally occurring only in men, and therefore primarily raises
psychological, cosmetic and social concerns. Idiopathic hirsutism (IH), where the
cause of excessive hair growth is unknown, is considered to be the most common
form of hirsutism. It is suspected that this type of hirsutism may be familial,
as there is often a family history of the condition. Women with IH will generally
have normal menses and normal levels of testosterone. There are many treatment
modalities that fall into two broad groups: medical and mechanical treatment. An
example of a medical treatment is when an agent is used, which interferes with
the synthesis of androgen at the ovarian or adrenal level, or by inhibiting the
effect of androgen at the receptor level. An example of a mechanical treatment is
laser hair removal, where the hair follicle is destroyed; however, much depends
on the on the skill of the treating practitioner, laser type, laser spot size,
skin type, hair colour, and the stage at which the hair follicles were during
their hair growth cycle, and the delivered wavelength. Laser offers the fastest
method of hair loss. Other mechanical treatments include electrolysis, depilatory
creams, plucking and waxing. This article presents a general overview of IH,
including a definition, diagnostic measures, clinical manifestations, normal and
abnormal physiology, and treatment options.

PMID: 18414261 [PubMed - indexed for MEDLINE]

Related Links

Guidance for the management of hirsutism. [Curr Med Res Opin. 2005] PMID:16083532

Management of hirsutism. [Australas J Dermatol. 1982] PMID:7183306

The evaluation and management of hirsutism. [Obstet Gynecol. 2003] PMID:12738163

Treatments for unwanted facial hair. [Skin Therapy Lett. 2005] PMID:16408139

Hirsutism and virilism in women. [Spec Top Endocrinol Metab. 1984] PMID:6084314

hair loss and hair loss treatment

Some other references on finasteride in hair loss treatment, etc.

Long-term (5-year) multinational experience with finasteride 1 mg in the
treatment of men with androgenetic alopecia. [Eur J Dermatol. 2002] PMID:11809594

Use of finasteride in the treatment of men with androgenetic alopecia (male pattern hair loss). [J Investig Dermatol Symp Proc. 2003] PMID:12894990

Progression of hair loss in men with androgenetic alopecia (male pattern hairloss): long-term (5-year) controlled observational data in placebo-treated patients. [Eur J Dermatol. 2008] PMID:18573713

Finasteride in the treatment of men with androgenetic alopecia. Finasteride Male Pattern Hair Loss Study Group. [J Am Acad Dermatol. 1998] PMID:9777765

Changes in hair weight in men with androgenetic alopecia after treatment with finasteride (1 mg daily): three- and 4-year results. [J Am Acad Dermatol. 2006] PMID:16781295

Interesting paper on finasteride from Merck.

Kaufman KD, Rotonda J, Shah AK, Meehan AG.,Long-term treatment with finasteride 1 mg decreases the likelihood of developing further visible hair loss in men with androgenetic alopecia (male pattern hair
loss). Eur J Dermatol. 2008 Jun 23;18(4):400-406

“There are no reports on the effects of pharmacologic treatment on the likelihood of developing further visible hair loss in men with androgenetic alopecia (AGA). Our objectives were to examine whether finasteride 1 mg treatment decreases the likelihood of developing further visible hair loss in men with AGA. We conducted an analysis of global photographic assessment data from two Phase III trials in which 1553 men with AGA received finasteride 1 mg/day or placebo for up to 5years. Finasteride 1 mg treatment led to a 93% decrease relative to placebo in the 5-year likelihood of developing further visible hair loss. We conclude that, in men with AGA, treatment with finasteride 1 mg/day over 5 years led to a marked and sustained decrease in the likelihood of developing further visible hair loss.