New Study on PRP, does this change your mind?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4622412/

The paper is interesting. Many people pre test platelet counts and then do platelet counts on the PRP obtained after it is spun down. If one were to take an average of perhaps 130cc of blood and spin it down, they would wind up with usually 6 or so cc of PRP. Platelet counts are usually 4-8 times the original platelet count. Sometimes maybe as high 10x the platelet count. These numbers may not correlate. I would want to know how many cc of prp did they get and did they dilute that with each patient. It is not clear why they compared different platelet concentrations for hair growth from the data presented here as these conclusions are not statistically significant based upon the data collected. There are no controls used in this study which by itself, disclaims many of the validity of the claims. I still remain skeptical


2019-02-12 07:11:25New Study on PRP, does this change your mind?

New Report that finasteride does not cause sexual side effects when compared to controlled group

I always tell my patients that the risk of sexual dysfunction or loss of libido was between 2-4% but this article suggests that these side effects were not seen in their study of over 600 men from all age groups. This suggests a strong psychological impact that could be the cause of the sexual complaints reporting “there is evidence of a nocebo effect (an adverse side-effect that is not a direct result of the specific pharmacological action of the drug)“. The link below is a copy of the article which should be read by our audience. The main thrust of the article, however, was that “recent researchsuggests that men with alopecia may be inherently more susceptible to sexual dysfunction regardless of treatment and that sexual dysfunction is not uncommon in the general population regardless of alopecia status.” I personally know the first author, Dr. Robert Haber and he is an honest and diligent clinician who I trust.

https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.15548?author_access_token=D24c_h79HLymV8uMhMZjRIta6bR2k8jH0KrdpFOxC64P8g8jjA3oxKEtIH6uG2i3wzguPsCnGEXe1jO-tZhF84ZrGEXnIpW-Wt9_oexeaNFlCp1ZbNfymVRdrP5xtRuy&


2019-05-29 07:46:16New Report that finasteride does not cause sexual side effects when compared to controlled group

New Propecia Persistent Sexual Side Effects Study Published

Snippet from the study abstract:

Methods. We conducted standardized interviews with 71 otherwise healthy men aged 21–46 years who reported the new onset of sexual side effects associated with the temporal use of finasteride, in which the symptoms persisted for at least 3 months despite the discontinuation of finasteride.

Results.  Subjects reported new-onset persistent sexual dysfunction associated with the use of finasteride: 94% developed low libido, 92% developed erectile dysfunction, 92% developed decreased arousal, and 69% developed problems with orgasm. The mean number of sexual episodes per month dropped and the total sexual dysfunction score increased for before and after finasteride use according to the Arizona Sexual Experience Scale (P < 0.0001 for both). The mean duration of finasteride use was 28 months and the mean duration of persistent sexual side effects was 40 months from the time of finasteride cessation to the interview date. Study limitations include a post hoc approach, selection bias, recall bias for before finasteride data, and no serum hormone levels.[/bq]
Read the full abstract — Persistent Sexual Side Effects of Finasteride for Male Pattern Hair Loss

This is new to me. We always try to follow publications, but remember that just because an article is published does not mean it is FACT and everyone needs to understand how the results were compiled. This was a paper based only on interviews of 71 men with sexual side effects only. I’m unsure about what lengths they went to find any underlying health issues or even conducting physical exams.

If this is true, then those men who develop sexual side effects will have a difficult decision. This has not been my experience in using and prescribing this drug for over 14 years. We have to make our decisions not just based on what we read, but also the methods of how the conclusions were based.

More info can be found at Time.com.

Newb Here. Thinking of Getting a Hair Transplant and Needed Advice (From Reddit)

ANSWER TO THE QUESTIONS BELOW:
  1. At the age of 38, you are certainly old enough to get a hair transplant. If you are really a Class 2, then it might mean that you are not balding but have been developing mature hairline. A good picture will go a long way for me to see what is really going on. If you want to send me photos, show me a front and side view with your eyebrows lifted high, so I can see where the hairline belong anatomically. (Send photos to wrassman@newhair.com)
  2. I think that trying a few hair transplant is nuts. That is like being a little bit pregnant. Once you have an anesthetic for a hair transplant, regardless of size, the transplant will accelerate the hair loss you may be having now. You will not have to shave your head for the hair transplant procedure.
  3. At 38, the use of medications like finasteride (Propecia) is something you would want to speak with your doctor about. People undergoing hair loss at the time of the transplant would be better on finasteride to prevent shock loss from occurring.
  4. Once the transplant is done, it is done. Follow-ups are more for you and your doctor to compare each of your expectations. A well done hair transplant does not require followup unless there are complications.
  5. A hair transplant requires the doctor to start up an operating room, break open supplies and instruments, and mobilize staff. This is the expense, even if I did 10 grafts. That expense is fixed and ties to the length of the surgery after the start-up costs.

Newb here. Thinking of getting a hair transplant and needed advice from tressless

New to Hair Loss — Which Products Work?

Hello,

I currently think I’m in the early stages of hereditary baldness. I have recently been researching if there is any products I can use early to prevent it from getting worse. Is there any products you would recommend?

I have recently read a about a product called “Profollica” which seems to have legit reviews but I’m skeptic. What is your opinion? Will this product work? I have also read about a product called “Procerin” & “Provillus”. Do any of the above products work?

I have Also red websites that have Said to get plenty of calcium in your Body as this helps the hair folicle. Your advise would be greatly appreciated.

Thank you

There are 2 medications that are proven to work — finasteride (Propecia) and minoxidil (Rogaine). Minoxidil is available in a generic form and over the counter, so it may be included in various products sold in stores as boutique brands. These brands are sometimes mixed with vitamins that likely won’t help treat your hair loss (particularly if your loss is due to genetic causes). Propecia is still a prescription medication and you’ll need to talk to your doctor about it.

As for the products you mentioned, if they contain finasteride or minoxidil they’ll probably help to some degree. If not, there’s no scientific proof that they’ll do what they claim. I’m sure I’ve written about each of them before if you use the search box in the top right of the site. Also, calcium won’t prevent genetic hair loss.


2010-11-09 12:23:31New to Hair Loss — Which Products Work?

Newspaper Daily Mirror 1909

I smiled when I saw these illustrations. Men often grow hair on the face and sideburns in many different iterations when they don’t have head hair. These photos are a look back in history over the past 150 years.

New Treatment for Genetic Balding in Men with Very Good Statistical Results Reported

Androgenetic Alopecia Treatment in Asian Men

| July 1, 2018

by Yohei Tanaka, MD, PhD; Toru Aso, MD, PhD; Jumpei Ono, MD; Ryu Hosoi, MD; and Takuto Kaneko, MD

Dr. Tanaka is with Clinica Tanaka Plastic, Reconstructive Surgery and Anti-aging Center in Matsumoto, Nagano, Japan, and the AGA Skin Clinic in Tokyo, Japan. Drs. Aso, Ono, Hosoi, and Kaneko are also with the AGA Skin Clinic in Tokyo, Japan.

Funding: No funding was provided.

Disclosures: The authors have no conflicts of interest relevant to the content of this article.

Abstract: Background. Androgenetic alopecia (AGA) is a common form of hair loss in Asian men. Although AGA is often regarded as a relatively minor dermatological condition, hair loss can impact self-image and is a main cause for anxiety and depression in some men. We have treated patients with AGA for seven years. Objective. The goal of this study was to evaluate the effectiveness of our combination therapy in Asian men with AGA. Participants. Between the years 2011 and 2017, 18,918 male patients were treated in our center. Our combination therapy consists of oral finasteride once daily, oral and topical minoxidil twice daily, and an injectable treatment of lidocaine and an AGA treatment solution comprising minoxidil, arginine, aspartic acid, caffeine, copper tripeptide, lysine, niacin, panthenol, propanediol, propylen glycol, retinyl palmitate, pyridoxine, sodium hyaluronate, and ubiquinone once monthly for more than six months. Measurements. Digital photographs were taken pre- and post-treatment, and patient assessments were recorded after six and 12 months post-treatment. Results. Significant improvement was observed in all patients in the digital photographs. Ninety-six and 80 percent of the patients reported satisfaction with the results of the treatment after six and 12 months post-treatment. Minor complications were observed in 802 (4.2%) patients, characterized by slight pain and bleeding due to injection, swelling, dizziness, itching, and erythema of the scalp. Slight pain was reported in 651 patients (3.4%), and slight bleeding was reported in 56 patients (0.3%). Sexual dysfunctions were uncommon. These minor complications resolved spontaneously. No treatment-related adverse events were observed. Conclusion. A combination of these therapeutic options offers safe and highly efficacious treatment for AGA with minimal complications.

Keywords: Androgenetic alopecia (AGA), Combination therapy, Finasteride, Hair loss, Minoxidil

J Clin Aesthet Dermatol. 2018;11(7):32–35

William Rassman, M.D. Comments: This is an impressive series of 18,000 Asian men where genetic patterned balding was treated. The general satisfaction rate is clearly defined and it is high. The article is easy to scan.


2018-08-21 19:30:20New Treatment for Genetic Balding in Men with Very Good Statistical Results Reported

New Your Times Article Giving Insight into Hair Stem Cells

Losing Your Hair? You Might Blame the Great Stem Cell Escape.

By observing mouse hair follicles, scientists discovered an unexpected mechanism of aging. “If I didn’t see it with my own eyes I wouldn’t believe it,” one said.

Credit…Alamy
Oct. 4, 2021

Every person, every mouse, every dog, has one unmistakable sign of aging: hair loss. But why does that happen?

Rui Yi, a professor of pathology at Northwestern University, set out to answer the question.

A generally accepted hypothesis about stem cells says they replenish tissues and organs, including hair, but they will eventually be exhausted and then die in place. This process is seen as an integral part of aging.

Instead Dr. Yi and his colleagues made a surprising discovery that, at least in the hair of aging animals, stem cells escape from the structures that house them.

“It’s a new way of thinking about aging,” said Dr. Cheng-Ming Chuong, a skin cell researcher and professor of pathology at the University of Southern California, who was not involved in Dr. Yi’s study, which was published on Monday in the journal Nature Aging.

The study also identifies two genes involved in the aging of hair, opening up new possibilities for stopping the process by preventing stem cells from escaping.

Charles K.F. Chan, a stem cell researcher at Stanford University, called the paper “very important,” noting that “in science, everything about aging seems so complicated we don’t know where to start.” By showing a pathway and a mechanism for explaining aging hair, Dr. Yi and colleagues may have provided a toehold.

Stem cells play a crucial role in the growth of hair in mice and in humans. Hair follicles, the tunnel-shaped miniature organs from which hairs grow, go through cyclical periods of growth in which a population of stem cells living in a specialized region called the bulge divide and become rapidly growing hair cells.

Sarah Millar, director of the Black Family Stem Cell Institute at the Icahn School of Medicine at Mount Sinai, who was not involved in Dr. Yi’s paper, explained that those cells give rise to the hair shaft and its sheath. Then, after a period of time, which is short for human body hair and much longer for hair on a person’s head, the follicle becomes inactive and its lower part degenerates. The hair shaft stops growing and is shed, only to be replaced by a new strand of hair as the cycle repeats.

But while the rest of the follicle dies, a collection of stem cells remains in the bulge, ready to start turning into hair cells to grow a new strand of hair.\

Together with a graduate student, Chi Zhang, Dr. Yi decided that to understand the aging process in hair, he needed to watch individual strands of hair as they grew and aged.

Ordinarily, researchers who study aging take chunks of tissue from animals of different ages and examine the changes. There are two drawbacks to this approach, Dr. Yi said. First, the tissue is already dead. And it is not clear what led to the changes that are observed or what will come after them.

He decided his team would use a different method. They watched the growth of individual hair follicles in the ears of mice using a long wavelength laser that can penetrate deep into tissue. They labeled hair follicles with a green fluorescent protein, anesthetized the animals so they did not move, put their ear under the microscope and went back again and again to watch what was happening to the same hair follicle.

Video

Cinemagraph
Colored arrows point to escaping stem cells on a hair follicle.CreditCredit…Rui Yi

What they saw was a surprise: When the animals started to grow old and gray and lose their hair, their stem cells started to escape their little homes in the bulge. The cells changed their shapes from round to amoeba-like and squeezed out of tiny holes in the follicle. Then they recovered their normal shapes and darted away.

Sometimes, the escaping stem cells leapt long distances, in cellular terms, from the niche where they lived.

“If I did not see it for myself I would not have believed it,” Dr. Yi said. “It’s almost crazy in my mind.”

The stem cells then vanished, perhaps consumed by the immune system.

Dr. Chan compared an animal’s body to a car. “If you run it long enough and don’t replace parts, things wear out,” he said. In the body, stem cells are like a mechanic, providing replacement parts, and in some organs like hair, blood and bone, the replacement is continual.

But with hair, it now looks as if the mechanic — the stem cells — simply walks off the job one day.

 

Image

Researchers manipulated the genes of this mouse. By 18 months old, it had rapid hair loss, but was otherwise healthy.
Credit…Rui Yi and Chi Zhang

But why? Dr. Yi and his colleagues’ next step was to ask if genes are controlling the process. They discovered two — FOXC1 and NFATC1 — that were less active in older hair follicle cells. Their role was to imprison stem cells in the bulge. So the researchers bred mice that lacked those genes to see if they were the master controllers.

By the time the mice were 4 to 5 months old, they started losing hair. By age 16 months, when the animals were middle-aged, they looked ancient: They had lost a lot of hair and the sparse strands remaining were gray.

Now the researchers want to save the hair stem cells in aging mice.

This story of the discovery of a completely unexpected natural process makes Dr. Chuong wonder what remains to be learned about living creatures.

“Nature has endless surprises waiting for us,” he said. “You can see fantastic things.”


2021-10-10 10:25:12New Your Times Article Giving Insight into Hair Stem Cells