Hair Loss Holistic Treatments Ebook

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Laserassisted Hair Transplantation

Concurrent with resurfacing technology was the suggestion that a narrow band of thermally damaged tissue should be hemostatic and might allow for rapid and bloodless hair transplantation by insertion of thin slits of hair-bearing skin or individual follicular units into slits or holes made by one of these lasers. Although with the CO2 laser a bloodless wound can be produced by either an UltraPulse laser or laser with rapid scanning, the amount of oxygen diffusion through this area and the rapidity of establishment of a vascular supply to the hair matrix was questionable and so, yet another controversy (363-366) began in the mid-1990s. Walter Unger (367-370), a prominent hair transplant surgeon, first reported his experience in 1994 with the UltraPulse laser. He thought that laser-recipient sites had good hair growth but that it was delayed compared to control cold steel grafts. Fitzpatrick

Example from the literature

Slevin et al. (1990) asked 106 consecutive patients with solid tumours to complete questionnaires about their willingness to receive chemotherapy. They were told that the more-intensive regimen was likely to have considerable side-effects and drawbacks, such as severe nausea and vomiting, hair loss, frequent tiredness and weakness, frequent use of drips and needles, admission to hospital, decreased sexual interest, and possible infertility. They were given different scenarios, such as (a) small (1 ) chance of cure, (b) no cure, but chance of prolonging life by three months, and (c) 1 chance of symptom relief only. All patients knew they were about to commence chemotherapy, and thus considered the questions seriously. Cancer nurses, general practitioners, radiotherapists, oncologists and sociodemographicallv matched controls were asked the same questions.

Insulin Resistance associated but not required for diagnosis

The most distinctive feature is that of clinical androgen excess. Hirsutism is usually present and can range from mild to severe. Usually hair growth is present on the face and chin as well as the lower abdomen. It is also not uncommon to see frontal hair loss and thinning of scalp hair.

C Role of the Wnt Pathway in Regulating EpSC Quiescence and Activation

The choice between quiescence and activation of EpSCs, whether in the interfollicular epidermis or the hair follicle bulge, involves the Wnt signal transduction pathway ending in Tcf Lef1, which also operates in the embryonic development of epidermal structures (Gat et al., 1998 Zhu and Watt, 1999 Das Gupta and Fuchs, 1999). The Wnt3 gene is expressed in developing and mature hair follicles and its receptor, Disheveled 2 (Dvl2) is expressed in a subset of cells in the outer root sheath and in precursor cells of the hair shaft (Millar et al., 1999). Overexpression of both Wnt3 and Dvl2 give a short-hair and cyclical balding phenotype in mice resulting from structural defects and an abnormal profile of protein expression in the hair shaft. In quiescent telogen hair follicles, Lef-1 represses the activity of EpSCs, because active GSK-3P prevents P-catenin from dissociating from the APC protein, which degrades P-catenin. At anagen, Wnt proteins activate EpSCs by inhibiting the enzyme...

Conditioning for bone marrow transplantation

Cyclophosphamide is given intravenously, usually in 250500 mL of saline over 0.5-1.0 h. Side-effects include nausea and vomiting (usually relatively mild), haemorrhagic cystitis, cardiomyopathy, fluid retention and alopecia. The haemorrhagic cystitis may be prevented or greatly modified by giving mesna (2-mercapto-ethane sulphonate) intravenously to neutralize the effects of metabolites of cyclophosphamide in the urine. Mesna (40 of the daily cyclophosphamide dose) is given intravenously 30 min before each cyclophosphamide infusion and the same dose is given at 3, 6, 9, 12, 16 and 20 h after each cyclophosphamide dose. This regimen is repeated on each day that the cyclophosphamide is given and the day after the last dose. The cardiotoxicity of cyclophosphamide is not usually a problem at the doses quoted unless there is already cardiac damage. Late haemorrhagic cystitis (after 20 days) may occur in transplant patients but is usually caused by virus infections (particularly adenovirus)...

Searching For New Indications

Once a drug is approved for an indication, many years of its patent life have usually expired. Information gathered from Phase III clinical trials or from use of the drug under normal conditions (postmarketing) may suggest alternative indications that may extend the patent life. For an invention to be patented in the USA, it must be a new and useful improvement and not obvious (see also Chapter 35). Patentable categories in drug development include pharmaceutically active compounds, processes for making compounds, and compositions comprising an active compound and a pharmaceutical carrier (Hammer 1990). New formulations may satisfy these criteria and extend the patent life, e.g. minoxidil (originally used orally as an antihypertensive agent) as a topical preparation for the treatment of hair loss. New indications also help to keep up the 'noise level' for the product, enabling the marketing team to capitalize on new information that could potentially expand the market for existing...

Etiology of erectile dysfunction after radical retropubic prostatectomy

Miller et al. examined whether changes in serum hormone levels influenced erectile dysfunction after radical prostatec-tomy.30 They found a statistically significant increase in serum testosterone, free testosterone, estradiol, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) as well as a decrease in dihydrotestosterone (DHT).30 This implies erectile dysfunction after radical prostatectomy can not be explained by androgen deficiency.

Direct brow lift browplasty

The extent of tissue excision is marked with the patient sitting upright aiming to position the scar within the upper row of brow hairs. The lower skin incision is made with the scalpel blade bevelled such that the incision is parallel to the hair shafts. This obviates transverse sectioning of the hair follicles thus minimising brow hair loss. Skin and subcutaneous tissue, with underlying orbicularis muscle as necessary, are excised taking care to identify and therefore avoid damage to the supraorbital neurovascular bundle. If surgery is undertaken for seventh nerve palsy then tissue excision down to the periosteum with deep fixation of brow tissue to periosteum using interrupted 4 0 Prolene sutures is necessary. The deeper tissues are closed with 4 0 or 5 0 Vicryl taking care to evert the skin edges prior to skin closure using a subcuticular 5 0 Prolene suture which is removed after five to seven days. This layered skin closure approach facilitates a thin flat scar.

Compare Alexithymia And Coping Style Between People With Ms And Other People

Picardi, A., Pasquini, P., Cattaruzza, M.S., Gaetano, P., Baliva, G., Melchi, C.F., Papi, M., Camaioni, D., Tiago, A., Gobello, T., & Biondi, M. (2003d). Psychosomatic factors in first onset alopecia areata. Psychosomatics, 44, 374-380. British Journal of Health Psychology, 7,213-225. Van der Donk, J., Hunfield, J., Passcher, J., Knegt-Junk, K., & Nieber, C. (1994). Quality of life and maladjustment associated with hair loss in women with alopecia androgenetica. Social Science and Medicine, 38, 159-163. Wahl, A.K., Gjengedal, E., & Hanestad, B.R. (2002). The bodily suffering of living with severe psoriasis in depth interviews with 22 hospitalised patients with psoriasis. Qualitative Health Research, 12,250-261.

Physiological Evidence of the Disease Process in the Brain

Psychiatric Rehabilitation

Many persons with schizophrenia and their families attribute the illness to psychological stress alone, a conclusion that is inconsistent with psychiatric research (Holzinger, Kilian, Lindenbach, Petscheleit, & Angermeyer, 2003). However, why would we assume that individuals who experience or observe a condition would necessarily know its origins Does being bald give you insight into the hormonal changes that have taken place to bring about hair loss Certainly not.

Psychological Model of Adjustment to Cancer

Inauthor Stirling Moorey

According to Moorey and Greer's cognitive model of adjustment, the personal meaning of cancer, based on an idiosyncratic appraisal of the threat to survival and the threat to the self, is an important determinant of an individual's adaptation to their disease. Moorey and Greer's model helps to explain why any two individuals with the same disease may react very differently to a diagnosis of cancer. For someone who has relied heavily on their appearance for self-esteem, treatment associated with hair loss or scarring may be devastating. Someone else who

Cell and molecular biology

Htr Telomerase

As the DKC1 -encoded protein dyskerin and hTR are both components of the telomerase complex (Figure 12.5), it now appears that DC arises principally from an abnormality in telomerase activity. Affected tissues are those that need constant renewal, consistent with a basic deficiency in stem cell activity due to defective telomerase activity. The demonstration of DKC1 and hTR mutations in DC families provides an accurate diagnostic test, including antenatal diagnosis, in a significant subset of cases (Table 12.6). For DC patients, this now also provides the basis for designing new treatments. For the wider community it provides the first direct genetic link between a human disease that is characterized by features of premature ageing (premature grey hair hair loss, early dental loss, abnormalities of skin pigmentation, nail dystrophy, bone marrow failure,

Ischaemic lower limb Chronic

E Examine the cardiovascular system, looking for signs of hyperlipidaemia, carotid bruits, signs of ischaemic heart disease, abdominal aortic aneurysm. If ischaemia is severe in lower limbs, there is shiny atrophic skin with hair loss or atrophic nails, ulcers tend to be painful and have a 'punched out' appearance (e.g. under toes or classically over lateral malleolus). Peripheries cool to the touch with prolonged capillary return time, weak or absent pulses. Listen for bruits. Buerger's test Elevation of the leg results in pallor, venous guttering, followed by dependent rubor.

Telomeres and Premature Aging

Among the first mouse models to show multiple signs of accelerated aging was the telomerase knockout mouse. These mice completely lack telomerase activity owing to a germ-line disruption in the gene encoding the essential telomerase RNA component, mTR (147). Interestingly, mTR- - mice are asymptomatic for the first three to four generations. Subsequent generations, however, are shorter lived and prematurely develop hair loss and graying, ulcerative skin lesions, delayed wound healing, reduced fertility, reduced stress resistance, and increased cancer. As noted earlier, mice have telomeres that are much longer than humans. It is notable, then, that the reduced longevity and fitness of mTR- - mice were not manifest until the mouse telomeres had substantially shortened to lengths more typical of those found in aged human tissues. Thus, this model demonstrates a critical role for telomere function not only in suppressing cancer, but also in ensuring many other aspects of organismal...

Prostate Epithelial Stem Cells

Neuroendocrine Cells Markers

The hierarchical relation between the cell types is schematically illustrated in Fig. 1. The exocrine lineage, resulting in the tall columnar prostate-specific antigen-producing cells, is critically dependent on the hormone, dihydrotestosterone. After castration, more than 90 of epithelial cells die

Structure Of The Skin

The basal layer also contains melanocytes which produce the pigment melanin, which imparts colour to the skin and also protects it from the effects of ultraviolet radiation. Other cells found in the epidermis include Langerhans cells, which play a role in the body's immune defences, and Merkel cells, which are involved in sensory reception. Structures such as hair follicles, nails, and sweat and sebaceous (oil-producing) glands are appendages that develop from the epidermis and extend into the dermis. The dermis contains blood vessels, nerves, hair follicles, sebum and sweat glands. A deep plexus of arteries and veins is found in the subcutaneous tissue, and this sends out branches to the hair follicles and various glands. A second network of capillaries is located on the sub-papillary region of the dermis. From this plexus, small branches are sent towards the surface layers of the skin. The capillaries do not enter the epidermis, but they come within 150 to 200 pm from the outer...

Top Hair Solution Medicine In World

Regenerative therapies are available for acute and chronic skin wounds, hair loss, periodontal injuries and disease, and diseases and injuries of the cornea. thickness skin grafts. They suffer several problems, however. First, lacking blood vessels, they are slow to vascularize if the underlying wound bed is severely damaged thus, ways are being sought to seed endothe-lial cells into the construct that will form blood vessels. Second, they do no better than MSTSGs alone in restoring cosmetic appearance, sensation, or skin functions such as thermal regulation, because the repaired skin has no hair follicles, sebaceous glands, or sweat glands. Third, they are cryopreserved until use, which reduces their cellularity. Thus, it is cheaper to use an acellular dermal regeneration matrix covered with keratinocytes or MSTSGs to treat wounds with deep dermal damage. The matrix slowly degrades as it is invaded by host fibroblasts, which repair the dermis. Male pattern baldness is a genetic...

Steroid Hormone Regulation Of Telomerase In The Prostate

The overall picture for the normal prostate is that telomerase is actively repressed in an androgen-dependent manner, and that activity is upregulated after androgen withdrawal. In sharp contrast, this normal regulation of telomerase is lost in prostate cancer, because the majority of primary tumors display robust telomerase activity despite the presence of normal levels of circulating androgens. In fact, with respect to telomerase regulation, the response of prostate cancer cells to androgen seems to be exactly the opposite that of normal cells. Not only are cancer cells telomerase positive in the presence of androgen but telomerase activity is suppressed after androgen withdrawal (Fig. 4) (201). For example, Guo et al. found that hTERT mRNA levels increased in the hormone-responsive prostate cancer cell line, LNCaP, when treated with the nonmetabolizable synthetic androgen, R1881 (202). This effect was considered to be indirect, based on the kinetics of the response and also the...

Psychological Aspects of Thyroid Cancer

Thyroid cancer patients who had been treated with radiation were almost twice as likely to report an overall effect on their health as those who had not received radiation. Almost a quarter of the sample described symptoms that could be associated with thyroid dysregulation, for example dry skin hair loss poor concentration sleep disturbance fatigue weight change palpitations heat cold intolerance diarrhea constipation depression anxiety. Thyroid cancer survivors reported psychological problems, memory loss, and migraine headaches more frequently than survivors of other types of cancer. The authors conclude that the morbidity associated with a diagnosis of thyroid cancer is significantly more pronounced than generally understood 13 .

Clinical Findings and Diagnosis

Granuloma Annulare The Scalp

Toe-web involvement is commonly bilateral, presenting with erythema, a burning sensation, pruritus and scaling, particularly of the fourth interdigital toe web space. Severe acute forms present with painful erythema and blistering in a similar pattern to that found in cases of acute eczema or pompholix. Patients with a history of atopy are predisposed to superficial infections by dermatophytes, and in these cases erythematous inflammatory fungal lesions coexist with patches of ecze-matous skin (Figure 9.18). Chronic plantar lesions develop asymptomatic large hyperkeratotic plaques and a particular form of toenail infection by T.rubrum manifests clinically as a subungual white onychomycosis. Varying degrees of temporary disability may result from severe infections. Children manifest scalp infections under the kerion clinical form with patches of nonscarring alopecia and boggy inflammation of the skin (Figure 9.19). Less commonly, adult travellers manifest...

Ar Structure And Function In The Prostate

The androgen hormone dihydrotestosterone (DHT) is the principal regulator of prostate development and growth during embryonal development and puberty (5). In the adult prostate, it is required for maintenance of tissue homeostasis and secretory function. The circulating steroid hormone, testosterone, diffuses into the cells and is there converted by the 5-a reductase enzymes to the more potent androgen, DHT (6). DHT and other androgen hormones present in the prostate cells bind to a high-affinity binding protein required for mediating their effects, the AR. It is a member of the superfamily of nuclear receptors, its closest relatives are the progesterone, glucocorticoid, and the other steroid hormone receptors (7,8). Binding of androgen hormones triggers activation of the receptor to a transcription factor that interacts with and regulates the activity of gene promoters containing androgen-responsive elements (AREs). Activation involves a cascade of activation processes and the...

Cognitive factors personality characteristics and core beliefs

Predisposing developmental factors are clearly linked to the development of several personality characteristics that are emerging as having predictive power in explaining some of the variability in adjustment. Whilst disrupted attachments in childhood have been discussed as having the potential to lead to stable attachment styles in adulthood, few studies have actually explored the role of attachment, and those that have, were unable to relate this directly back to early experiences. Picardi et al. (2003b, c, d) found higher levels of insecure and avoidant attachment styles in a small sample of people with newly diagnosed or recently exacerbated vitiligo and alopecia areata. Interestingly, their participants also had poorer levels of social support and it was hypothesised that this might result from difficulties in accessing social support as a result of the underlying attachment style. Two other cognitive factors have recently attracted attention in this area, alex-ithymia and...

Major depressive disorder

Depression is encountered in a wide range of other dermatological disorders (Panconesi, 1984 Gupta & Gupta, 1996 Woodruff et al., 1997 Picardi et al., 2000 Gupta & Gupta, 2003 Picardi et al., 2004 Sampogna et al., 2004). Depression may modulate pruritus perception in other pruritic skin disorders such as atopic dermatitis and chronic idiopathic urticaria in addition to psoriasis (Gupta et al., 1994). Higher anxiety and depressive symptoms (Ullman et al., 1977 Hashiro & Okumura, 1998 Kiebert et al., 2002 Zachariae et al., 2004) have been reported in patients with atopic dermatitis. The anxiety may be the feature of an underlying depressive illness in some of these patients. Chronic intractable eczema during childhood may be a sign of a disturbed parent child relationship (Koblenzer & Koblenzer, 1988) however, a major depressive disorder should be ruled out before a disturbance in the family dynamics is implicated (Allen, 1989). Chronic idiopathic urticaria has been associated with a...

Stimulation Of Hair Regeneration

Androgenetic alopecia, or male pattern baldness, is a genetic predisposition in which there is thinning and loss of the hair on the temples and crown of the scalp in an M -shaped pattern (Springer et al., 2003). The cause is sensitivity of hair follicles in these regions to the hormone dihydrotestosterone (DHT), which is formed in scalp cells from testosterone by the action of the enzyme 5-a-reductase. DHT acts to progressively shorten the anagen stage of hair growth while lengthening telogen, resulting in smaller hair follicles, thinner and shorter hairs and ultimately, many empty and involuted hair follicles. The follicles on the sides and back of the scalp are not responsive to DHT and so are spared. The standard treatment for pattern baldness is the transplantation of clusters of 1-4 follicles from the sides and back of the scalp to the temples and crown, very close together, a time-consuming and expensive process. Two over-the-counter medications, minoxidil (marketed as Rogaine...

Side Effects Of Selenium And Vitamin E

Excess levels of selenium ingestion can be quite toxic. Selenium supplements have been associated with gastrointestinal problems, pathologic nailbed changes and the loss of fingernails, temporary hair loss and even fatigue.62 However, at 200 g day these side effects, apart from some gastrointestinal upset were not observed in a past trial,3 but for the patient who believes in the 'more is better' theory, this could represent a potential problem. Clinicians need to advise patients on the potential harm that could result from taking too much supplemental selenium. A CDC report from 1983 highlights the dangers of high selenium intake.62 Individuals were taking a selenium supplement that actually contained hundreds of more micrograms and milligrams than was reported on the purchased bottle. This resulted in temporary and permanent nail and hair loss, and fatigue that was mentioned earlier.

Cutaneous Lupus Erythematosus


All forms of cutaneous lupus may manifest photosensitivity. Cases with acute SLE may present with the characteristic butterfly facial rash in addition to constitutional symptoms, whereas subacute cutaneous lupus occurs in about 10 of patients with lupus erythematosus. Common skin presentations include an annular scaly erythematous, psoriasiform rash involving light-exposed areas, which may present abruptly, extensor surfaces of arms, dorsa of hands, V of chest and upper back and face. Patients may also manifest a diffuse nonscarring alopecia. The treatment of choice is topical steroids in mild cases but systemic therapy with antimalarials, corticosteroids, and immunosupressants is usually required. Chronic forms of discoid LE present with weeks-to-months history of erythematous papules and plaques with follicular plugging and atrophy, with subsequent scar formation. The rash tends to occur on habitually exposed areas of the face, scalp, external ears, and hands. Scalp involvement...

Development of QoL research in dermatology

A 21-question format was suggested in 1970 to record, in a standard way, the impact of skin disease on QoL (Whitmore, 1970). Other suggestions concerning criteria for assessing the impact of permanent skin impairment (Committee, 1970) and systems for wider assessment of disability (Robinson, 1973) were also proposed. The first dermatology disease-specific instrument, the Psoriasis Disability Index (PDI) (Finlay & Kelly, 1985 Kelly & Finlay, 1987) was initially used to assess the impact of hospital admission on disability in patients with psoriasis and has subsequently been used widely (Lewis & Finlay, 2004). The use of validated, standardised general health measures in dermatology, such as the UK Sickness Impact Profile (Finlay et al., 1990) and the Short Form-36 (SF-36) (Nichol et al., 1996) followed in the early 1990s. Several dermatology disease-specific QoL measures for use in acne, psoriasis, atopic dermatitis, alopecia, leg ulcers and others were described during the 1990s and...

BDD and other body image pathologies

BDD presents as a preoccupation with an imagined defect in appearance or if a slight anomaly is present, the individual's concern is excessive (American Psychiatric Association, 1994). BDD is also referred to as dysmorphophobia and 'dermatological non-disease' (Cotterill, 1981) in the dermatological literature. In one study 8.8 of patients with mild acne had BDD (Uzun et al., 2003). The complaints in BDD commonly involve imagined or slight flaws of the face or head such as thinning hair, acne, wrinkles, scars, vascular markings, paleness or redness of the complexion, swelling, facial disproportion or asymmetry, or excessive facial hair. The most common areas of concern involve the skin and hair. Some associated features of BDD include repetitive behaviours such as excessive grooming behaviour. This may manifest as excessive hair combing, hair removal, hair picking or picking of the skin, or ritualised make-up application. The main purpose of the repetitive behaviour is to improve or...

The AR and Androgens

Strategies for hormonal therapy. LH-RH Luteinizing hormone-releasing hormone CRH corticotropin-releasing hormone LH luteinizing hormone ACTH adrenocorticotropic hormone T testosterone 5a-R 5a-reductase DHT 5a-dihydrotestosterone AR androgen receptor. Fig. 1. Strategies for hormonal therapy. LH-RH Luteinizing hormone-releasing hormone CRH corticotropin-releasing hormone LH luteinizing hormone ACTH adrenocorticotropic hormone T testosterone 5a-R 5a-reductase DHT 5a-dihydrotestosterone AR androgen receptor.

Genetic Theories

Another avenue of interest in the study of prostate cancer has been the effect of circulating androgens. Testosterone and its most active metabolite, dihydrotestosterone, are the principal steroid hormones involved in the growth and development of the prostate gland. Serum levels of these hormones have

Risk Factors

For prostate cancer, the most important risk factor is also prolonged exposure to steroid hormones, i.e. androgens. Early castration or genetic defects blocking androgen synthesis essentially eliminate the risk of prostate cancer, while more subtle abnormalities, such as qualitative differences in the levels of circulating androgens or qualitative differences in androgen receptor function or related signal transduction pathways due to various genetic polymorphisms may also alter the risk of prostate cancer in certain subpopulations.9 For example, genetic variations of 5a-reducatase may create more productive enzymatic conversion of testosterone to dihydrotestosterone (DHT), which has been suggested as one mechanism of increased prostate cancer risk.10 Studies have looked at the potential role of vitamin D receptor (VDR) polymorphisms in prostate cancer risk, particularly in African American men.11 It has also been noted that Black men of college age have 13 higher serum free...

Causal Models

This model assumes that a poor QoL is likely to be manifested by psychological distress, and that psychological distress is a latent variable that tends to result in anxiety, depression, despair, irritability and similar signs of distress. This much does seem a plausible model. However, a patient with poor QoL need not necessarily have high levels of all treatment-related symptoms. For example, a patient receiving chemotherapy may well suffer from hair loss, nausea, vomiting, and other treatment-related side-effects that cause deterioration in QoL. However, other cancer patients receiving non-chemotherapy treatments could be suffering from a completely different set of symptoms and side-effects that cause poor QoL for other reasons.


FIGURE 3.7 Diagram showing how Wnt proteins activate quiescent EpSCs of the hair follicle to become transit amplifying (TA) cells. At telogen, Lef-1 acts as a transcriptional repressor in the absence of P-catenin (P-C), which is degraded by GSK-3p. At anagen, Wnt activates the Disheveled 2 (Dvl-2) protein, which inactivates GSK-3p. P-C is stabilized and translocates to the nucleus, where it forms a complex with Lef-1 that stimulates gene transcription characteristic of TA cells. FIGURE 3.7 Diagram showing how Wnt proteins activate quiescent EpSCs of the hair follicle to become transit amplifying (TA) cells. At telogen, Lef-1 acts as a transcriptional repressor in the absence of P-catenin (P-C), which is degraded by GSK-3p. At anagen, Wnt activates the Disheveled 2 (Dvl-2) protein, which inactivates GSK-3p. P-C is stabilized and translocates to the nucleus, where it forms a complex with Lef-1 that stimulates gene transcription characteristic of TA cells. P-catenin to dissociate from...


All of the personality and cognitive factors described above have clear links to the types of coping strategies deployed by individuals. Shame-proneness, alex-ithymia, and avoidant-attachment style have all been linked to avoidant-coping strategies. For example, vitiligo and alopecia areata participants with higher levels of insecure and avoidant-attachment styles also had poorer levels of social support and it was hypothesised that this might result from difficulties in being able to access social support (Picardi et al., 2003b, c, d).

Vitamin D Action

1,25-VD, the bioactive form of vitamin D, was identified as a nutrient a century ago, and is the major regulator of calcium and phosphate homeostasis, responsible for maintenance of bone integrity, and also plays an important role in hair follicle cycling and mammary gland development. The biological effects of 1,25-VD are mainly mediated through the VDR, a member of the nuclear receptor superfamily, which heterodimerizes with the retinoid X receptor (RXR) and binds to response elements located in the promoters of target genes in various tissues, such as bone (osteocalcin, osteopontin, and beta 3 integrin), kidney (24-hydroxylase), and intestine (calbindin).6,7 Like other nuclear receptors, VDR contains an amino-terminal activation function 1 (AF-1) domain, a DNA binding domain (DBD), composed of two hexameric half-sites organized as direct repeats that recognize specific DNA response elements, and a ligand binding domain (LBD) that contains a ligand-regulated transcriptional...

Genetic Factors

Results for the androgen receptor (AR), which is involved in androgen binding and transport, are fairly consistent, showing that shorter CAG repeat lengths are associated with increased risk in most, but not all, pop-ulations.100-119 For the type II steroid 5a-reductase (SRD5A2), which converts testosterone to the more active androgen dihydrotestosterone, the results are mixed,110,119-133 with a recent meta-analysis showing modest

Sebaceous cysts

T B D Epithelium-lined, keratinous, debris-filled cyst arising from a blocked hair follicle. More correctly known as epidermal cyst. iP Despite their name, these cysts are not derived from sebaceous glands. Sebaceous cysts result from the cystic proliferation of epidermal cells within the dermis. The source of this epidermis is often the infundibulum of the hair follicle. Inflammation is usually a foreign body, granulomatous reaction to material contained within the cysts.

Hormonal Therapy

Finasteride and flutamide combined as androgen ablative therapy for advanced prostate adenocarcinoma have been studied. Finasteride inhibits 5a-reductase, decreases the conversion of testosterone to 5a-dihydrotestosterone and provides a more complete intraprostatic androgen block-ade.104 Combined therapy with these agents decreased serum prostate specific antigen (PSA) greater than either agent alone and accounted for an overall potency rate of 82 -with potency defined as the ability to maintain an erection satisfactory for sexual intercourse.104 Combined hormonal therapy has the promise of delivering sufficient androgen blockade while maintaining adequate erectile dysfunction. Greenstein et al. found that surgical castration with orchi-ectomy reduced serum testosterone to a level not statistically different than that with hormonal castration.108 Orchiectomy is associated with decreased potency and sexual activity.

Cancer Chemotherapy

Cancer chemotherapy, first experimented with in 1943 by employing mustard gas alkylating agents (DeVita et al., 1997), is typically associated with severe side effects because highly toxic compounds are used. This can be explained by the fact that most chemotherapeutic agents interfere with the cell division process. Not only cancer cells but also dividing healthy cells are tackled by the agent, with undesired side effects such as nausea, vomiting, diarrhea, hair loss, and serious infection as a consequence (Boyle and Costello, 1998).

Coronal brow lift

A bevelled high coronal incision is made within the hairline following the shape of the latter far enough posterior to position the subsequent scar 3-4cm posterior to the anterior hairline. The incision is angled to run parallel with the axis of the hair follicles down Post operative haematoma leading to flap necrosis, localised sensory and motor nerve damage, hair loss and unacceptable scarring are all recognised complications, the majority of which can be avoided with careful surgical technique.


Colon, E.A., Popkin, M.K., Callies, A.L., Dessert, N.J., & Hordinsky, M.K. (1991). Lifetime prevalence of psychiatric disorders in patients with alopecia areata. Comprehensive Psychiatry, 32, 245-251. Gulec, A.T., Tanriverdi, N., Duru, C., Saray, Y., & Akcali, C. (2004). The role of psychological factors in alopecia areata and the impact of the disease on the quality of life. International Journal of Dermatology, 43, 352-356. Gupta, M.A., & Gupta, A.K. (1998). Depression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis and psoriasis. British Journal of Dermatology, 139(5), 846-850. Gupta, M.A., Gupta, A.K., & Watteel, G.N. (1997). Stress and alopecia areata a psychodermato-logic study. Acta Dermato-Venereologica (Stockholm), 77, 296-298. Koo, J.Y.M., Shellow, W.V., Hallman, C.P., & Edwards, J.E. (1994). Alopecia areata and increased prevalence of psychiatric disorders. International Journal of Dermatology, 33, 849-850. Ruiz-Doblado, S.,...

Saw palmetto

The biochemical basis for the activity of saw palmetto against benign enlargement of the prostate almost certainly includes inhibition of the formation of dihydrotestosterone (DHT) within the prostate gland. Interestingly, saw palmetto inhibits formation of DHT in the prostate gland, but not in many other tissues and may not alter blood levels of this hormone.48,49 The action of testosterone and dihydrotestosterone on the prostate gland is markedly stimulated by the hormone, prolactin. Saw palmetto is reported to block the response of prostate cells to prolactin.50

Laser Hair Removal

Thermally nonselective but effective destruction of hair follicles in hair-bearing grafts, or for trichiasis, had been reported as early as the 1970s (393 -396) but hair removal by thermal damage confined to the hair follicle governed by the principle of selective photothermolysis had not been attempted. The first FDA-approved laser for hair removal did not depend on the pigmented hair as a target but instead a patented mineral oil lotion was used containing carbon-based material, which was presumed to seep into the follicles after waxing immediately prior to massaging of the lotion and thus provide a target for the laser. Presumably, the mechanico-acoustic wave appearing after the laser impact would then disrupt the base of the follicle so that the loosened hair would fall out and the damaged follicle would no longer produce hair. In 1995 Goldberg and coworkers (397,398) presented the first studies showing very short-term efficacy. Hyperbole from the mass media was unfortunately not...

Acute Pancreatitis

HUMAN HAIR GROWTH CONTROL (ALOPECIA) AND DERMATOLOGIC DISORDERS Functional TRPV1 is expressed in keratinocytes, hair follicles, sebocytes and sweat gland cells 151, 152 . In organ cultures, activation by capsaicin of TRPV1 results in premature hair follicle regression and apoptosis 153 . This finding confers a therapeutic potential for TRPV1 antagonists in the treatment of alopecia. In prurigo nodularis, enhanced TRPV1 expression was found that normalized during capsaicin treatment 154 .

Anti Androgens

Spironolactone is an anti-mineralocorticoid agent that also acts as an anti-androgen. It is a potassium sparing diuretic that in high doses (100-200 mg day) demonstrates significant anti-androgenic properties. Spironolactone interferes with testosterone biosynthesis by reducing 17-hydroxylase activity and thus lowers plasma testosterone. It also inhibits dihydrotestosterone's binding to the androgen receptor. It is not FDA-approved for treatment of androgenic symptoms but in many studies has been shown to be an effective agent in this regard. It is often combined with oral contraceptives to reduce testosterone action and production. is a nonsteroidal, nonhormonal antiandrogenic drug, which has been demonstrated to block the action of dihydrotestosterone (DHT) on androgen receptors. It has been associated with hepatocellular dysfunction. Finasteride is a 4-aza analog of testosterone and is a competitive inhibitor of both tissue and hepatic 5-alpha reductase. This results in inhibition...


The proliferation and differentiation of prostate tissue are modulated by growth factors15,16 as well as hormonal androgen therapy.17,18 Evidence of hormonal impact on the prostate is seen in atrophy of the prostate following castration,4 as well as treatment of BPH samples with a 5a-reductase inhibitor. When this inhibitor is given to patients, there is a regression of dihydrotestosterone (DHT) levels and a reduction in prostate volume.19,20 Recent data suggests that mutations in RNase L predispose men to an increased incidence of prostate cancer, which in some cases reflect more aggressive disease and or decreased age of onset compared with

Hormonal activity

Dihydrotestosterone (DHT), the 5a-reduced product of testosterone, binds to androgen receptors with 2.5-fold higher affinity than testosterone itself, and serves as the major regulator of prostatic tumor growth. Androgen-mediated cancer proliferation occurs by direct effects of androgens, indirectly by

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