Introduction: Androgenic alopecia is a progressive alteration of the scalp with few treatment options, which motivates the search for new local or systemic medications to control this pathology.
Objective: To evaluate patient tolerance for and identify the action mechanism of the Cellium® GC compound in the treatment of androgenic alopecia.
Methods: Male patients (n = 20) with androgenic alopecia participated in this open prospective study. The compound was used on the scalp twice a day, at home, for 12 con- secutive weeks. Biopsies were carried out before and after treatment to evaluate the alterations in the cutaneous immune response, cellular proliferation and anti-apoptosis activity. Questionnaires were administered to evaluate efficacy and patient satisfaction.
Results: Nineteen patients completed the study, with an average satisfaction of 8.3 out of 10. Immunohistochemical analyses of scalp biopsies showed a significant increase in the cutaneous immune response after treatment: 73.9% increase in CD1A+ Langerhans cells (p = 0.003, t paired test), 41.7% increase in the cellular proliferation marker Ki-67+ (p = 0.012), and an 89% increase in BCL-2+ anti apoptotic proteins (p = 001). The product was also found to be tolerable and safe.
Conclusions: Cellium® GC improved the skin''''''''s immune defense and the proliferation of keratinocytes, and produced high levels of patient satisfaction in the treatment of androgenic alopecia.

Keywords: ALOPECIA, BIOPSY, KERACINOCYTES, MINOXIDIL

In hair transplants, the donor area can supply only a limited number of follicular units in each procedure. In the treatment of more advanced degrees of baldness, removing both a scalp strip and follicular units, one by one, is an option that allows more units to be harvested in a single session, thus providing a better density and coverage of the bald area. This article describes a technique called Untouched Strip, which, in addition to increasing the number of follicular units with the combined procedure, preserves the donor area for a possible future transplant.

Keywords: HAIR, TRANSPLANTATION, ALOPECIA

Introduction: Telogen effluvium is a chronic progressive alopecia of multifactorial etiology. Nutritional deficiency-sometimes subclinical-can trigger it. Objective: To evaluate the influence of a nutritional supplementation at physiological doses in patients with telogen effluvium. Methods: The supplementation of nutrients in food doses was carried out in 60 female patients for 180 days. Results: There was a significant improvement (p <0.05) in hair loss, which was confirmed by digital phototrichogram, where there was a significant increase in anagen hairs and reduction of telogen hairs. Conclusion: The present study demonstrated that in cases of telogen effluvium without an apparent cause, the replenishment of nutrients related to the hair cycle has a significant benefit in the regression of the picture as soon as after three months of treatment.

Keywords: ALOPECIA; NUTRIENTS; HAIR.

Lichen planus pigmentosus is a rare variant of lichen planus and represents a therapeutic challenge. Dermabrasion was performed with a good clinical response in the treatment of this condition, on the face of a female patient who also bears frontal fibrosing alopecia.

Keywords: DERMABRASION; LICHENOID ERUPTIONS; ALOPECIA.

Introduction: The loss of dermal density and thickness, characterized by sagging and thinning skin, may be related to various conditions such as aging (both intrinsic and extrinsic) as well as abrupt changes in body mass - such as pregnancy or increased weight - and the resulting rupture of collagen fibers. Some nutrients can positively affect the dermal metabolism, thus improving its functional properties. Objective: To evaluate clinically and through ultrasound the effect of a nutritional supplement on the thickness of the dermis and on its functional properties. Methods: Twenty-eight female patients between the ages of 35 and 65 years, with facial sagging complaints, used the supplement for 90 days, having been evaluated subjectively and through ultrasound for clinical safety and efficacy. Results: The studied nutritional supplement provided a significant increase in dermal thickness after 30 days of use, in the areas evaluated. There was significant improvement in the firmness, elasticity, hydration and overall appearance of the skin. No adverse reaction related to the product was observed during the study period. Conclusions: The nutritional supplement was effective in improving the conditions of the dermis, increasing its thickness and clinical parameters of firmness, elasticity, and hydration, and has been proven safe and well-tolerated when used as instructed.

Keywords: COLLAGEN; DERMIS; NUTRIENTS; SKIN AGING

Androgenetic alopecia is a condition with an important psychological impact. Clinical treatments present variable responses and require care for long periods, a factor that decreases the chances of adhesion. Microneedling with or without minoxidil injection is a new treatment modality. This study reports cases of two male patients, aged 30 and 44 years, with satisfactory partial response to four sessions of microneedling with minoxidil and three sessions of microneedling alone, using a tattoo machine and microinfusion of drugs into the skin technique.

Keywords: ALOPECIA; MINOXIDIL; NEEDLES

Introduction: Brittle nails or nails that do not grow are relatively frequent complaints in the dermatological practice, nonetheless there are few studies on how nutrition influences these symptoms.
Objective: To evaluate the possible influence of nutritional supplementation for improving the nail plate's resistance and growth.
Methods: Forty-five patients complaining of fragile/brittle nails were observed for 16 weeks under recommended daily intake of a nutritional supplement containing vitamins and trace elements, having undergone clinical and subjective evaluations in Weeks 8, 12 and 16.
Results: There were improvements in the parameters strength, resistance, growth and nail integrity from Week 8, with further progress after continued use of the supplement, allowing the conclusion that this treatment led to noticeable improvement of the nail plate's quality.
Conclusions: The nutritional supplement evaluated was safe and effective in improving the signs of nail weakening, including loss of resistance and reduction of growth rate.

Keywords: NAIL DISEASES; NUTRIENTS; KERATINOCYTES

Introduction: Androgenetic alopecia is the most common type of hair loss in men and women. Nowadays, medication based treatments are the most frequently used nevertheless they yield poor results. More recently, the use of lasers has been proposed to treat this condition. At the same time, the infiltration of medications in the scalp has also been growing as a therapeutic option, although there are few scientific studies on this treatment modality.
Objective: To evaluate the results of using 1,550nm Erbium-Glass laser associated with the injection of active principles (minoxidil, finasteride, growth factors and a vitamin complex) for the treatment of male and female androgenetic alopecia.
Methods: A retrospective study was carried out with patients with androgenetic alopecia diagnosis, who underwent monthly sessions of the proposed combination therapy. The results were evaluated by means of comparative photographs taken before and after the treatment period and the assessment of the patients' opinion.
Results: Sixty-two patients were treated with 3 to 14 sessions; 48.39% of patients had mild improvement, and 46.77% had significant improvement. The vast majority (96.77%) was satisfied with the treatment. The patients who were very satisfied with the outcomes underwent a greater number of sessions (more than six, on average).
Conclusions: The association of 1,550nm Erbium-Glass laser therapy with the injection of active principles in the scalp is an effective and safe option for the treatment of androgenetic alopecia.

Keywords: ALOPECIA; LASERS; THERAPEUTICS

Intradermotherapy, also known as mesotherapy, is a non-surgical procedure, minimally invasive consisting of multiple applications of pharmacological substances diluted by intradermally or subcutaneously. Adversities already been reported after treatment mesoterápico as alopecia, lichenoid rash, oleoma, psoriasis induction and skin infections. There is scant scientific information on the subject, and few studies with more rigorous methodology of the efficacy and mechanism of action of intradermally. Knowing this, there was this article having a complicating account of this method in a patient of our service, and elucidate some of its benefits and other complications.

Keywords: MESOTHERAPY; ALOPECIA; HAIR DISEASES

Introduction: Latanoprost has been shown to have potential for the treatment of hair loss evidenced by increased thickness and length of eyelashes and hypertrichosis that can be observed when it is used in the periorbital region.
Objective: To evaluate the effectiveness of latanoprost, used isolatedly or in associations, for reducing hair loss and/or stimulating its growth in patients bearers of telogen effluvium or androgenic alopecia.
Methods: A comparative, double-blind study was carried out during 180 days, with 6 groups: G1 - placebo, G2 - 5% minoxidil, G3 - 5% minoxidil + 0.005% latanoprost, G4 - 0.005% latanoprost, G5 - 5% minoxidil + 0.010% latanoprost, G6 - 0.010% latanoprost. The total and percentage count of hair strands was carried out based on phototrichogram in the anagen and telogen phases.
Results: There was improvement in G2 (total number of hair strands, number of anagen strands in D92 and D180), G3 (total number of hair strands and number of anagen hair strands in D242), G4 (total number of strands in D182, and number of anagen hair strands in D92 and D182), and G5 (total number of hair strands in D182, percentage of telogen and anagen hair strands and number of anagen hair strands in D92 and D182). Treatment of G6 did not yield significant difference regarding the placebo.
Conclusions: The treatments with 5% minoxidil, 5% minoxidil + 0.005% latanoprost, 0.005% latanoprost, 5% minoxidil + 0.010% latanoprost were shown effective in controlling hair loss and in increasing the total number of hair strands.

Keywords: Alopecia; Hair; Minoxidil

Introduction: The use of nutraceutical products in the treatment of chronic telogen effluvium of non-specific cause – associated or not with signs and symptoms of nail plate frailty – has been proposed in the literature. Supplementation of nutrients and trace elements that are crucial to follicle’s metabolism seems to be linked to this effect.
Objective: To evaluate the efficacy of a nutraceutical containing vitamins A, C, E and B complex, folic acid, iron, niacin, biotin, zinc and calcium pantetonate, among others, in the treatment of telogen effluvium associated with the brittle nails syndrome.
Methods: A clinical, prospective, open and monocentric study was carried out with the evaluation of 62 volunteers. Clinical evaluation measurements – based on digital phototrichogram and imaging – were performed at the baseline, and at 45 and 90 days after the use of the studied product.
Results: At the end of the study, a statistically significant (p <0.05) reduction of 31.56% in the number of telogen strands could be observed, coupled with a significant improvement in clinical parameters related to hair and nails. The instrumental evaluation based on image analysis showed a 36.63% reduction in nail desquamation, which, although not statistically significant, has shown benefits in the absolute outcome.
Conclusions: The use of nutraceuticals was proven effective in the treatment of telogen effluvium associated with the brittle nails syndrome.

Keywords: Alopecia; Dietary supplements; Nails

Introduction: The number of women seeking treatment for androgenetic alopecia has increased during the last decade. Likewise, a greater amount of therapeutic options and methods for evaluating treatment efficacy have also become available. In face of this, it is necessary to develop simple and objective methods to quantitatively evaluate the effectiveness of hair treatments.
Objective: To validate a quantitative method that evaluates the effectiveness of treatments for hair loss.
Methods: Comparison of standardized photographs obtained before and after the treatments, analyzed by a software that provides automatic calculation of the area of hair loss in square pixels. This calculation is based on the contrast perceived between bright (hair loss) and dark (normal amount of hair) regions of the scalp, and allows estimating the area that is not covered by hair, thus quantifying the effectiveness of the treatments.
Results: The method is effective for assessing the affected area in patients with both initial and advanced degrees of hair loss.
Conclusions: The proposed method allows evaluating the effectiveness of diverse types of treatments for telogen effluvium and androgenetic alopecia in a rapid, straightforward and cost effective manner.

Keywords: Alopecia; Hair; Methodology; Methods

Alopecia areata is a chronic condition of hair follicles and nails with unknown etiology, which causes hair loss. It emerges in several clinical types, with the diffuse form, where there is acute and diffuse hair loss, being atypical. It is generally accepted that there is a T-cell mediated, organ-specific autoimmune base in alopecia areata and studies indicate that the autoantigen is associated with melanocytes. The authors of the present paper report the case of a patient who had the diffuse form of alopecia areata, with preservation of the gray hair strands

Keywords: Alopecia Areata; Alopecia; Autoantigens; Hair

INTRODUCTION: The skin aging process includes a functional decline of the scalp’s structures, with progressive atrophy of the dermis and follicular dermal papillae, which are crucial to the nutrition and metabolism of the hair follicle. These phenomena are directly related to a poor quality of the hair shaft.
OBJECTIVE: To evaluate the influence of a combination of nutrients on the keratinogenesis in the follicular dermal papilla.
METHODS: Cell cultures of human dermal papillae were incubated with a combination of A, C, D, E and B-complex vitamins, in addition to trace elements and keratin amino acids during 72 hours, in three different concentrations. These cultures were compared to an untreated control-culture. The papilla’s fibroblasts cell proliferation rate was determined after 72 hours.
RESULTS: The diverse concentrations evaluated promoted significant increase in cell proliferation as compared to the control group, however there was no significant difference between the concentrations studied.
CONCLUSION: The studied association of nutrients was capable to significantly act on the proliferation of cells in the human hair follicle’s dermal papilla, restoring more favorable conditions for the synthesis of the hair shaft. These findings demonstrate the presence of a significant potential in the approach strategy various causes of alopecia, including alopecia related to aging (senescent).

Keywords: Alopecia; Aging; Dermis; In vitro techniques; Nutrients

Janus kinase inhibitors have changed the therapeutic paradigm of severe alopecia areata therapy. Some patients are refractory to dosage escalating. In this article, we describe the applicability of adjuvant oral minoxidil therapy.

Keywords: Alopecia; Alopecia Areata; Hair Janus Kinases; Minoxidil