Treatment of Hair Loss at the Proctor Clinic.
Hair Loss Treatment at the Proctor Clinic. Regrowth of hair using our special formulations
J Invest Dermatol.1985;83:118
Distribution of epidermal growth factor receptors in rat tissues during embryonic skin development, hair formation, and the adult hair regrowth cycle.
Green MR, and Couchman JR.
In a previous study a close positive correlation was found between epidermal growth factor (EGF) receptor tissue distribution and areas of potential epithelial cell proliferation. We now report on the binding distribution of EGF, representing the tissue localization of available EGF receptors, during embryonic rat skin development including hair follicle formation and the adult hair growth cycle....snip...Between 17 and 20 days embryonic development, available receptors for EGF are consistently absent from epidermal basal cells overlaying the dermal condensates marking the first stage of hair follicle development. This restricted and temporary loss of EGF receptors above these specialized mesenchymal condensates implies a role for the EGF receptor and possibly EGF or an EGF-like ligand in stimulating the epithelial downgrowth required for hair follicle development. In the anagen hair bulb, receptors for EGF are detected over the outer root sheath and the epithelial cell layers at the base of the follicle and show a correlation with the areas of epithelial proliferation in the hair bulb. During the catagen and telogen phases of the hair cycle, receptors are observed in high numbers on all the undifferentiated or dedifferentiating cells of the degenerating epithelial strand and secondary hair germ. Dermal cells are, in general, less heavily labeled than the basal epithelial cells of skin except for the developing striated muscle (panniculus carnosus) in embryonic skin which is more heavily labeled. The data are discussed in terms of a possible role for the EGF receptor and associated EGF or EGF-like ligands in specific areas of epithelial tissue morphogenesis during embryonic skin maturation, hair follicle development, and hair cycling.
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Hair loss and hair loss treatment
Androgens play a pivotal role in the growth of pubic and axillary hair. Androgens stimulate growth of beard hair, whereas in the scalp, androgens inhibit hair regrowth. Clinical studies by James B. Hamilton in the early 1940's suggested that the balding process is promoted by androgens in genetically predisposed men, referred to as androgenetic alopecia or male pattern hair loss. The androgen acting in the scalp to promote the balding process was not known at the time. It was not until the 1960's when it was discovered that testosterone is converted to the more bioactive androgen dihydrotestosterone by the microsomal, NADPH-dependent enzyme steroid 5alpha-reductase in peripheral androgen-responsive tissues such as the prostate and skin [4]. Two genes encoding two isoenzymes of steroid 5alpha-reductase exist, designated type 1 and type 2 [5, 6]. The type 1 isoenzyme is the major 5alpha-reductase in skin, has a neutral pH optimum and a low affinity for testosterone. Steroid 5alpha-reductase type 2, on the other hand, is the major isoenzyme in the prostate, has an acidic pH optimum and a high affinity for testosterone. The notion that DHT, and not testosterone, is the androgen responsible for benign prostate hyperplasia and male pattern hair loss stems from the observation that men with steroid 5-alpha-reductase 2 deficiency present with a hypoplastic prostate and do not develop male pattern baldness . Consequently, the 5 alpha-reductase type 2 isoenzyme-specific inhibitor finasteride has proven efficacious in promoting hair regrowth as a consequence of lowering scalp and plasma DHT levels, and in the treatment of benign prostate hyperplasia by lowering prostatic DHT.
Hair Loss Treatment at the Proctor Clinic
A history of Redox signaling.
Redox cell signaling is an important process in hair loss and in hair loss treatment agents.
Indian J Plast Surg. 2009;42:63
Surgical treatment of secondary cicatricial Hair loss of scalp and eyebrow.
Hassan AS. wr al
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Secondary cicatricial alopecia occurs as a result of destruction of hair follicles by scar tissue formed in the scalp and eyebrows. It is a permanent condition and regrowth of hairs in the area is not expected. The purpose of the study was to select the appropriate method for treating cicatricial alopecia. 24 patients were admitted to our hospital during the period from June 2006 to July 2007. They were suffering from acquired cicatricial alopecia affecting the scalp and the eyebrow. Their ages ranged from 6-48 years with mean age 26-25 years. They were treated surgically by total excision of the lesions with direct closure of the defect in ten cases, excision of alopecia with advancement flaps with the aid of scalp expanders in seven cases, scalp reduction through serial excision of alopecia in three cases and excision of alopecia and reconstruction of the hair loss defect by strip composite hair-bearing scalp grafts in four cases. Our results suggest there are three key factors that decide the surgical methods for treating alopecia: size, location and shape. We also discuss and evaluate the various techniques of reconstruction. Good results were obtained in 18 patients.
Postgrad Med. 1977;:122.
Dermatoses: common in blacks.
Kenney JA Jr.
Some skin disorders are more common in blacks than in whites or are so rare in whites as to be almost peculiar to blacks. Pigmentary abnormalities, either dark or light spots, often occur in association with inflammatory skin diseases. Curvature of the hair follicle is thought to be at the root of two other painful conditions, pseudofolliculitis of the beard and keloidal folliculitis. Certain hairstyles and treatments are damaging and can even cause hair loss if continued.
hair loss treatment at the Proctor clinic
Dr Proctor's coments on Stroke and uric acid. Many of the same treatment modalities that work in hair loss treatment also ameliorate stroke.
Folha Med. 1951;32(:121
Case of baldness treated with pantothenic acid alcohol.
ABIRACHED IA.
PMID: 14879858
Dr Proctor comments: The original paper reporting that pantothenate works some for hair loss treatment
Singh G. Androgenic alopecia. Indian J Dermatol Venereol Leprol 2002;68:40
Pattern hair loss is a genetically determined physiological event, the exact mode of inheritance of which is unknown. The shortening of the anagen phase of the hair cycle leads to the consequent increase in the proportion of telogen hairs. Autosomal dominant inheritance with increased penetrance in males had been suggested, but there are reports of multifactorial inheritance as well. The role of androgen along with their interaction with genetic factors is demonstrated in men, but in women baldness is often associated with elevated levels of circulating androgens (e.g. in polycystic ovary disease). In both the sexes, the factor determining androgenic alopecia is the manner in which the follicles of the frontal and vertex region of the scalp react to the circulating androgens. Till date the correlation between testosterone levels and the extent of baldness has not been established. snip
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Transplantation. 1987;44:83
Long-term survival of skin allografts in rats treated with topical cyclosporine.
Lai CS, et al
The use of topical cyclosporine (CsA) was studied in skin allografts from Buffalo to Lewis rats. CsA prepared in olive oil and dimethyl sulfoxide was administered in various dosages topically on allografts. Untreated allografts were rejected in 7.4 days but survived for 18. or 40.6 days after 10, 20, or 28 days of topical CsA treatment (10 mg/rat/day), respectively. Long-term graft survival (greater than 100 days) was seen with continuous CsA treatment at 10 mg/rat/day, 10 mg/rat/2 days, and 5 mg/rat/day, as compared with rejection in 13.1 +/- 2.3 and 8.9 +/- 0.9 days with CsA 10 mg/rat/3 days and 5 mg/rat/2 days, respectively. The therapeutic blood level of CsA ranged from 250 to 500 ng/ml. Most grafts were rejected when CsA blood levels fell below 200 ng/ml. Direct administration of topical CsA onto the allografts resulted in longer survival compared with those applied on the normal recipient skin 6 cm distal to the allografts, with both high and low doses. Locally high concentrations of CsA in allografts may play an important role in prolongation of graft survival. Minimal cell infiltration and loss of hair follicles were the main histological features in long-surviving allografts.
Edited for hiar regrowth blod use. cyclosporin sometimes stimulates hair regrowth.
Eur J Dermatol.1999;9:111
Pronounced perifollicular lymphocytic infiltrates in alopecia areata are associated with poor treatment response to diphencyprone.
Freyschmidt-Paul P, et al
Some authors have reported that severe destruction of follicular structures and even scarring patterns occur in those patients with hair loss due to alopecia areata (AA) who fail to respond with regrowth to treatment with contact sensitizers, such as diphencyprone (DCP). Other studies, however, gave contradictory results. Therefore, we re-examined histopathological changes in scalp samples obtained from 85 patients with severe hair loss before initiation of DCP treatment (40 responders and 45 non-responders in terms of hair regrowth). The following parameters were evaluated: i) perifollicular lymphocytic infiltration; ii) perifollicular fibrosis, and iii) miniaturized hair follicles. No difference between responders and non-responders could be observed in the degree of miniaturization of hair follicles and proliferation of perifollicular fibrous tissue. In neither group was there any evidence of scarring or severe follicular destruction. 18 non-responders who did not regrow hair but only 6 responders to hair loss treatment showed a very dense perifollicular lymphocytic infiltration. In contrast, a particularly scarce infiltrate was seen in 9 non-regrowers and in 19 responders. We conclude that non-responders tend to have pronounced inflammatory reactions with dense perifollicular lymphocytic infiltrates.
Lab Anim Sci. 1983;33:192
Demodectic mange in a tamarin.
Hickey TE, et al
A young female tamarin (Saguinus geoffroyi) developed erythema, hai rloss , and papule formation on the skin of the limbs, tail, and head. Examination of skin scrapings and a biopsy specimen revealed mites identified as Demodex sp. Histologically the mites were found in hair follicles, and they were associated with focal degenerative and inflammatory changes in the skin. Successful treatment included topical application of 1% ronnel solution and rotenone ointment.
Hair Loss treatment at the Proctor clinic.
Can Med Assoc J.1979 18;121:428-30, 433
Familial hypogonadotropic hypogonadism with hair loss
Slti IS, Salem Z.
In one family several male and female members had hypogonadism and frontoparietal hair loss, whereas other members with normal sexual development had normal scalp hair. Clinical and laboratory evaluation of three affected young men (two brothers and their cousin) revealed that the hypogonadism was the result of decreased serum concentrations of follicle stimulating and luteinizing hormones. There was no evidence of a deficiency of any other pituitary hormone. snip..
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J Dermatol Surg Oncol. 1977;3(2):220
Use of steel pins in hair transplantation.
Johnson WC, Baker GK
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Steel pins are used to stabilize hair transplants by preventing transplanted plugs from becoming elevated, depressed or turned in the wrong direction. The pinning procedure is less traumatic to hair follicles than is tight bandaging and bleeding is more easily controlled. Patients so treated have improved final appearances. The authors' technique of using steel pins is described.
JAMA Dermatol. 2013 May 22:1-5. doi: 10.1001/jamadermatol.2013.3049. [Epub ahead of print]
Autoimmune, Atopic, and Mental Health Comorbid Conditions Associated With Alopecia Areata in the United States.
Huang KP, Mullangi S, Guo Y, Qureshi AA.
Abstract
OBJECTIVE To evaluate the prevalence of comorbid conditions among patients with alopecia areata (AA) seen at tertiary care hospitals in Boston, Massachusetts, during an 11-year period. DESIGN Retrospective cross-sectional study. SETTING Tertiary care hospitals in Boston, including Brigham and Women's Hospital and Massachusetts General Hospital. PARTICIPANTS We identified 3568 individuals with AA seen in the Partners health care system in Boston between January 1, 2000, and January 1, 2011. We performed comprehensive searches of the Research Patient Data Repository using International Classification of Diseases, Ninth Revision code 704.01. We randomly selected 350 patients and manually reviewed their medical records to train and validate a novel artificial intelligence program. This program then used natural language processing to review free-text medical records and confirm a diagnosis of AA. To confirm the algorithm, we manually reviewed a subset of records and found 93.9% validity. MAIN OUTCOMES AND MEASURES The prevalence of comorbid conditions was assessed. RESULTS Common comorbid conditions included autoimmune diagnoses (thyroid disease in 14.6%, diabetes mellitus in 11.1%, inflammatory bowel disease in 6.3%, systemic lupus erythematosus in 4.3%, rheumatoid arthritis in 3.9%, and psoriasis and psoriatic arthritis in 2.0%), atopy (allergic rhinitis, asthma, and/or eczema in 38.2% and contact dermatitis and other eczema in 35.9%), and mental health problems (depression or anxiety in 25.5%). We also found high prevalences of hyperlipidemia (24.5%), hypertension (21.9%), and gastroesophageal reflux disease (17.3%). This profile was different from that seen in a comparison psoriasis and psoriatic arthritis group. CONCLUSIONS AND RELEVANCE We found a high prevalence of comorbid conditions among individuals with AA presenting to academic medical centers in Boston. Physicians caring for patients with AA should consider screening for comorbid conditions.
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Adv Nurse Pract. 1999 Apr;7(4):39-42, 83. Hair-raising. The latest news on male-pattern baldness.
Proctor PH.
The initiating event in balding seems to be an abnormal sensitivity to the male sex hormones. In addition, a multifactorial model is emerging in which hormones affect the hair follicle in a way that causes it to be perceived as a foreign body by the immune system, which then mounts an attack. Several new classes of agents have the potential to treat hair loss. More than 40 U.S. and several hundred foreign patents have been issued for hair-loss treatment agents. As is common in dermatology, no single agent works universally against hair loss, so the treatment process is often one of trial and error.
This is a paper by Dr. Proctor