Carbon Dioxide Fractional Laser Treatment Induces Lgr5+ Stem Cell Activation and Hair Regrowth Through the Canonical Wnt/ß-Catenin Pathway.

BACKGROUND: Different types of alopecia have negative impacts on patients. Recently, some kinds of laser or light therapies have been reported to effectively alleviate hair loss. Carbon dioxide fractional laser (CO2FL) treatment is one of the most effective laser treatments, but its beneficial effects and exact mechanism in hair regrowth have not been reported in detail. The purpose of this study was to investigate the effect and molecular mechanism further. METHODS: C57 and Lgr5-Cre: Rosa-mTmG mouse models of hair regrowth were established by CO2FL treatment, and the parameters that induced the best effect were determined. Tissues were harvested on the day prior to the treatment day and on days 3, 5, 7, 10 and 14 after CO2FL. H&E and immunofluorescence staining, RNA sequencing (RNA-seq), quantitative real-time polymerase chain reaction (qPCR), Western blotting (WB) and related inhibitor were used to determine the molecular mechanism underlying the effect of CO2FL treatment on the hair cycle and hair regrowth. In clinical trial, five participants were treated three sessions at 1-month intervals to obverse the effects. RESULTS: Hair regrew and covered the treatment area on the tenth day after CO2FL treatment with the best parameters, while the control group showed signs of hair growth on the 14th day. H&E and immunofluorescence staining showed that the transition of hair follicles (HFs) from telogen to anagen was accelerated, and the rapid activation and proliferation of Lgr5+ hair follicle stem cells (HFSCs) were observed in the treatment group. The RNA-seq, qPCR and WB results indicated that the Wnt pathway was significantly activated after CO2FL treatment. Improvement achieved with CO2FL treatment in clinical trial. CONCLUSIONS: The results of this study suggest that CO2FL treatment can promote hair regrowth by activating Lgr5+ HFSCs and upregulating the Wnt/ß-catenin pathway. Clinical trial results demonstrated that CO2FL treatment will be a promising therapeutic regimen for alopecia. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Quantitative Analysis of Hair Luster in a Novel Ultraviolet-Irradiated Mouse Model.

Hair luster is a key attribute of healthy hair and a crucial aspect of cosmetic appeal, reflecting the overall health and vitality of hair. Despite its significance, the advancement of therapeutic strategies for hair luster enhancement have been limited due to the absence of an effective experimental model. This study aimed to establish a novel animal model to assess hair gloss, employing ultraviolet (UV) irradiation on C57BL/6 mice. Specifically, UVB irradiation was meticulously applied to the shaved skin of these mice, simulating conditions that typically lead to hair luster loss in humans. The regrowth and characteristics of the hair were evaluated using a dual approach: an Investigator's Global Assessment (IGA) scale for subjective assessment and an image-based pixel-count method for objective quantification. These methods provided a comprehensive understanding of the changes in hair quality post-irradiation. To explore the potential reversibility of hair luster changes, oral minoxidil was administered, a treatment known for its effects on hair growth and texture. Further, to gain insights into the underlying biological mechanisms, bulk RNA transcriptomic analysis of skin tissue was conducted. This analysis revealed significant alterations in the expression of keratin-associated protein (KRTAP) genes, suggesting modifications in hair keratin crosslinking due to UV exposure. These changes are crucial in understanding the molecular dynamics affecting hair luster. The development of this new mouse model is a significant advancement in hair care research. It not only facilitates the evaluation of hair luster in a controlled setting but also opens avenues for the research and development of innovative therapeutic strategies. This model holds promise for the formulation of more effective hair care products and treatments, potentially revolutionizing the approach towards managing and enhancing hair luster.

Antioxidant Properties of Platycladus orientalis Flavonoids for Treating UV-Induced Damage in Androgenetic Alopecia Hair.

BACKGROUND: Androgenetic alopecia (AGA) causes thinning hair, but poor hair quality in balding areas and damage from UV radiation have been overlooked. Plant extracts like Platycladus orientalis flavonoids (POFs) may improve hair quality in AGA. This study examines POFs' effectiveness in treating AGA-affected hair and repairing UV-induced damage. METHODS: Hair samples were analyzed using scanning electron microscopy (SEM) to examine surface characteristics, electron paramagnetic resonance (EPR) spectroscopy to measure free radicals in the hair, and spectrophotometry to assess changes in hair properties. RESULTS: POFs effectively removed hydroxyl radicals from keratinocytes and had antioxidant properties. They also reduced UV-induced damage to AGA hair by mitigating the production of melanin free radicals. Following POF treatment, the reduction in peroxidized lipid loss in AGA hair was notable at 59.72%, thereby effectively delaying the progression of hair color change. Moreover, protein loss decreased by 191.1 µ/g and tryptophan loss by 15.03%, ultimately enhancing hair's tensile strength. CONCLUSION: compared to healthy hair, hair damaged by AGA shows more pronounced signs of damage when exposed to UV radiation. POFs help protect balding hair by reducing oxidative damage and slowing down melanin degradation.

Human pollution exposure correlates with accelerated ultrastructural degradation of hair fibers.

Exposure to pollution is a known risk factor for human health. While correlative studies between exposure to pollutants such as polycyclic aromatic hydrocarbons (PAHs) and human health exist, and while in vitro studies help to establish a causative connection, in vivo comparisons of exposed and nonexposed human tissue are scarce. Here, we use human hair as a model matrix to study the correlation of PAH pollution with microstructural changes over time. Two hundred four hair samples from 2 Chinese cities with distinct pollution exposure were collected, and chromatographic-mass spectrometry was used to quantify the PAH-exposure profiles of each individual sample. This allowed us to define a group of less contaminated hair samples as well as a more contaminated group. Using transmission electron microscopy (TEM) together with quantitative image analysis and blind scoring of 82 structural parameters, we find that the speed of naturally occurring hair-cortex degradation and cuticle delamination is increased in fibers with increased PAH concentrations. Treating nondamaged hair fibers with ultraviolet (UV) irradiation leads to a more pronounced cortical damage especially around melanosomes of samples with higher PAH concentrations. Our study shows the detrimental effect of physiological concentrations of PAH together with UV irradiation on the hair microstructure but likely can be applied to other human tissues.

Photoreactivity of Hair Melanin from Different Skin Phototypes-Contribution of Melanin Subunits to the Pigments Photoreactive Properties.

Photoreactivity of melanin has become a major focus of research due to the postulated involvement of the pigment in UVA-induced melanoma. However, most of the hitherto studies were carried out using synthetic melanin models. Thus, photoreactivity of natural melanins is yet to be systematically analyzed. Here, we examined the photoreactive properties of natural melanins isolated from hair samples obtained from donors of different skin phototypes (I, II, III, and V). X-band and W-band electron paramagnetic resonance (EPR) spectroscopy was used to examine the paramagnetic properties of the pigments. Alkaline hydrogen peroxide degradation and hydroiodic acid hydrolysis were used to determine the chemical composition of the melanins. EPR oximetry and spin trapping were used to examine the oxygen photoconsumption and photo-induced formation of superoxide anion, and time-resolved near infrared phosphorescence was employed to determine the singlet oxygen photogeneration by the melanins. The efficiency of superoxide and singlet oxygen photogeneration was related to the chemical composition of the studied melanins. Melanins from blond and chestnut hair (phototypes II and III) exhibited highest photoreactivity of all examined pigments. Moreover, melanins of these phototypes showed highest quantum efficiency of singlet oxygen photogeneration at 332 nm and 365 nm supporting the postulate of the pigment contribution in UVA-induced melanoma.

Antioxidant extracts from Dicerocaryum senecioides as active ingredients in semi-permanents and hair conditioners.

BACKGROUND: Different hair types respond differently to cosmetic treatments; hence, many options ought to be availed to the consumer. The purpose of this study was to evaluate the use of antioxidant extract from Dicerocaryum senecioides as active alternatives in hair semi-permanent waving and hair conditioning. METHODS: The antioxidant phytochemicals were first identified and isolated by thin-layer chromatography (TLC) and spraying with revealing agents. The antioxidant potency was determined by DPPH antiradical scavenging and ferric reducing power methods. The extract was incorporated in two different formulations to make the extract perm (bio-semi-permanent) and the antioxidant hair conditioner (AC). The formulations had their performance examined for hair curling and conditioning on Asian and African hair types. Hair damage was assessed by scanning the surface of treated samples on an attenuated total reflectance-Fourier transform infrared spectrometer (ATR-FTIR) and by quantifying lost protein on ultraviolet visible (UV-Vis) spectrophotometer. RESULTS: The extract antioxidant had an IC50 of 26.54 ± 0.34 µg/ml exhibiting greater antioxidant potency compared to the controls quercetin (38.84 ± 0.12 µg/ml) and ascorbic acid (35.22 ± 0.07 µg/ml). The extract perm had a lower curling ability indicated by a perm set of 85.10 ± 3.92% and 81.35 ± 2.35% for Asian and African hairs, respectively, while commercial product, ammonium thioglycolate (ATG) had 96.05 ± 1.70% and 93.60 ± 2.21% for the same. The curling of hair with extract perm resulted in less oxidative damage with oxidative peak areas of 3.37 ± 0.09 and 3.71 ± 0.03 as well as lower protein losses of 4.72 ± 0.71 µg/mg and 5.62 ± 0.70 µg/mg on Asian and African hair samples, respectively. The application of AC reduced the oxidative damage peak areas of ATG and extract perm treated Asian hair samples by 1.15 and 0.48 units, respectively. AC was also effective in reducing damage caused by UV radiation on ATG-treated samples by 1.06 units (African hair) and 1.09 units on Asian hair. CONCLUSION: The results show antioxidant extracts from Dicerocryum senecioides as a promising and safer alternative for hair conditioning and semi-permanent curling.

CONTEXTE: les réactions aux traitements cosmétiques varient d'un type de cheveux à l'autre. Ainsi, de nombreuses options doivent être mises à disposition des consommateurs. Cette étude avait pour objectif d'évaluer l'utilisation d'un extrait antioxydant de Dicerocaryum senecioides en vue de proposer de nouveaux choix de produits actifs pour les mises en plis semi-permanentes et le conditionnement capillaire. MÉTHODES: les agents phytochimiques antioxydants ont d'abord été identifiés et isolés par chromatographie sur couche mince (CCM) et par pulvérisation d'agents révélateurs. La puissance antioxydante a été déterminée par une méthode de piégeage antiradicalaire à l'aide du DPPH et par un procédé de puissance de réduction du fer. L'extrait a été incorporé dans deux formulations différentes pour obtenir la permanente (semi-permanentes biologiques) et l'après-shampooing capillaire antioxydant. Les performances des formulations ont été évaluées selon des critères de bouclage et conditionnement capillaires sur des cheveux de types asiatiques et africains. L'évaluation des lésions capillaires reposait sur un examen de la surface des échantillons traités à l'aide d'un spectromètre infrarouge à transformée de Fourier en réflectance totale atténuée (attenuated total reflectance Fourier transform infra-red spectrometer, ATR-FTIR) et sur une quantification des protéines perdues à l'aide d'un spectrophotomètre à ultraviolet visible (UV-Vis). RÉSULTATS: l'extrait antioxydant présentait une concentration inhibitrice médiane (IC50 ) de 26.54 ± 0.34 µg/ml, d'où une plus grande puissance antioxydante par rapport aux produits témoins, à savoir la quercétine (38.84 ± 0.12 µg/ml) et l'acide ascorbique (35.22 ± 0.07 µg/ml). La permanente présentait une plus faible capacité de bouclage, révélée par un taux de fixation de la permanente de 85.10 ± 3.92 % et de 81.35 ± 2.35 % pour les cheveux asiatiques et africains respectivement, tandis que le produit disponible dans le commerce, à savoir le thioglycolate d'ammonium (ATG), donnait des taux de 96.05 ± 1.70 % et de 93.60 ± 2.21 % dans les mêmes conditions. Le bouclage des cheveux à l'aide de la permanente a entraîné moins de lésions oxydatives, avec des zones de pics d'oxydation de 3.37 ± 0.09 et de 3.71 ± 0.03, ainsi que des pertes protéiques plus faibles, de 4.72 ± 0.71 µg/mg et de 5.62 ± 0.70 µg/mg sur les échantillons de cheveux asiatiques et africains respectivement. L'application de l'après-shampooing antioxydant a permis de réduire de 1.15 unité les zones de pics d'oxydation due à l'ATG sur les échantillons de cheveux asiatiques et la permanente a permis de traiter ces mêmes échantillons à raison de 0.48 unité. L'après-shampooing antioxydant s'est également avéré efficace pour réduire les lésions causées par les rayons UV sur les échantillons traités par ATG, de 1.06 unité sur les cheveux africains et de 1.09 unité sur les cheveux asiatiques. CONCLUSION: les résultats montrent que les extraits antioxydants de Dicerocaryum senecioides constituent une option prometteuse et plus sûre pour le conditionnement capillaire et les mises en pli semi-permanentes.

A Combined Triple-Wavelength (755nm, 810nm, and 1064nm) Laser Device for Hair Removal: Efficacy and Safety Study.

BACKGROUND: Photoepilation by a single-wavelength laser device is being commonly used for hair removal. Whether emitting multiple laser wavelengths to induce hair unit damage would be beneficial is yet to be established. OBJECTIVE: To evaluate the safety and efficacy of hair reduction using a novel simultaneous multi-wavelength laser device. PATIENTS AND METHODS: A retrospective cohort study was carried out among adult males. Hairy sites were treated by a simultaneous triple-wavelength (755nm, 810nm and 1064nm) laser device (Soprano Titanium. Caesarea, Israel: Alma Lasers Ltd). Treatment parameters were: fluence of 7-9J/cm2, pulse frequency of 9-10Hz and spot sizes of 2cm2 or 4cm2. Participants underwent up to 6 treatments at 6-8 weeks intervals and were followed for 4-6 months. Clinical photography before and after treatment was documented. Treatment efficacy was assessed using Global Aesthetic Improvement Scale (GAIS; scale of 0 [no improvement] to 4 [excellent improvement; Over 75% hair reduction]) by two independent dermatologists. Participants’ satisfaction was rated on a scale of 1 (not satisfied) to 5 (very satisfied). Pain perception and adverse events were recorded as well. RESULTS: A total of 27 treatment sites among 11 participants, with Fitzpatrick skin type III-V, were included. Mean hair reduction was 3.4 out of 4 in the GAIS. Participants' satisfaction rate was high (mean, 4.8). No adverse events were recorded. CONCLUSION: Simultaneous triple-wavelength laser device is a safe and effective hair removal modality. J Drugs Dermatol. 2020;19(5): doi:10.36849/JDD.2020.4735.

Long-term Facial and Body Hair Removal With a Combined Radiofrequency and Optical Home-Use Device for All Skin Types.

OBJECTIVES: To evaluate long term effectiveness and safety with the use of a combined radiofrequency and optical home hair removal device in all skin types and over both facial and body areas. METHODS: A combined intense pulsed light (IPL) and radiofrequency (RF) home device was used for hair removal. Two separate study designs were evaluated. In the first design, bilateral body areas were treated with 7 weekly procedures and then unilateral areas received up to 12 monthly maintenance treatments while the corresponding other side received no further therapy. For the second design, facial areas received 4 procedures in 2 to 5 days visits, followed by 2 weekly, and then 6 biweekly procedures. All patients in both study designs had hair count evaluations up to 12 months post their last procedure. The highest energy used was 4 J/cm². RESULTS: In the first design, 58 subjects participated of which 15% were skin types V-VI. A total of 188 anatomical sites were treated. Hair reduction at 6 and 12 months post the last procedure was 56% and 52% respectively for the maintenance side and 47% and 37% for the non-maintenance side. For the second design, 19 subjects had 59 facial sites treated. Fifteen percent were skin types V –VI. The overall hair reduction at the end of receiving their procedures was 45%. At 12 months post the last procedure, the hair reduction was 42%. Aside for transient mild erythema, there were no adverse effects noted. CONCLUSIONS: Long term persistent hair reduction was achieved using an RF/IPL home-use hair reduction device. The combination of RF and optical energies allowed for the effective application of low energy usage. All skin types and both facial and body anatomical regions tolerated the procedures very well. J Drugs Dermatol. 2020;19(5):498-503. doi:10.36849/JDD.2020.4741.

UV damage to hair and the effect of antioxidants and metal chelators.

OBJECTIVE: To study the effects of addition of a redox metal, copper, antioxidants and metal chelators on the formation of free radicals in natural white Caucasian hair subsequently exposed to UV light. Three different methods, electron paramagnetic resonance (EPR), a fluorescent probe for hydroxyl radical formation (terephthalate) and free radical photoyellowing, were used. These methods utilized different UV sources and reaction conditions, and so can give insights into the different mechanisms of action occurring during UV oxidation of hair. In addition, this study demonstrates how antioxidants and chelators can be screened to determine whether they can protect hair from UV damage. RESULTS: The three methods gave somewhat different results, illustrating the importance of reaction conditions and wavelength on the photochemical mechanisms, and the efficacy of additives to influence these reactions. EPR results showed that N-acetylcysteine (NAC) pre-treatment eliminated the intensity of the signal because of sulphur and carbon free radicals in white hair both before and after exposure to UVB radiation. Doping the hair with copper ions had no effect on the intensity of the EPR signal under dry conditions. Terephthalate fluorescent probe data showed that under wet conditions, irradiation of white hair with UVA produced significant amounts of hydroxyl radicals. Pre-treatment of hair with NAC reduced the number of •OH radicals produced by natural white hair compared to an untreated control. In contrast to the EPR result, white hair doped with copper ions produced significantly higher levels of •OH radicals under wet conditions. It appears that the ability of copper ions to catalyse the photogeneration free radicals in hair is highly dependent on water content. Photoyellowing data showed a benefit for oxalic acid but no difference for NAC and an increase in yellowing for EDTA. CONCLUSION: The micro-EPR and terephthalate fluorescent probe methods are both effective techniques to study production of free radicals by hair exposed to UV light under wet and dry conditions, respectively. Both assays are simple methods for determining the effectiveness of potential protective hair treatments against UV damage, but because they assess free radical damage under dry vs wet conditions, the chemistry created on UV exposure is different. This gives insights into mechanism of action, but results may not be consistent between the two methods for actives added for reduction of UV damage. NAC pre-treatment did reduce free radical generation in UV-exposed hair under both wet and dry conditions. Photoyellowing data are more complicated as it is a less direct measure of UV damage and is highly dependent on irradiation source. Using UVB irradiation is experimentally convenient but may not be appropriate, because UVB wavelengths comprise only 0.3% of terrestrial sunlight. The photochemistry of hair exposed to sunlight involves concurrent photobleaching and photoyellowing processes and is far more complex. Under UVB irradiation conditions, oxalic acid showed a yellowing benefit.

OBJECTIF: Étudier les effets de l'ajout d'un métal redox, d'un cuivre, d'antioxydants et de chélateurs de métaux sur la formation de radicaux libres dans les cheveux naturels blancs de Caucasiens, exposés par la suite à des rayons  à ultraviolets. Trois méthodes différentes, la résonance paramagnétique électronique (RPE), une sonde fluorescente pour la formation de radicaux hydroxyles (téréphtalate) et le photojaunissement dû aux radicaux libres ont été utilisées. Ces méthodes ont utilisé différentes sources d'UV et de conditions de réaction, et peuvent par conséquent donner un aperçu des différents mécanismes d'action qui se produisent lors de l'oxydation des cheveux aux UV. Par ailleurs, cette étude montre comment les antioxydants et les chélateurs peuvent être analysés en vue de déterminer s'ils peuvent protéger les cheveux contre les dommages causés par les UV. RÉSULTATS: Les trois méthodes ont donné des résultats quelque peu différents, ce qui illustre l'importance des conditions de réaction et de la longueur d'onde sur les mécanismes photochimiques, ainsi que l'efficacité des additifs influençant ces réactions. Les résultats de la RPE ont montré que le traitement préalable par N-acétylcystéine (NAC) éliminait l'intensité du signal en raison de la présence du soufre et des radicaux libres de carbone dans les cheveux blancs, avant et après l'exposition aux rayons UVB. Le dopage des cheveux avec des ions de cuivre n'a eu aucun effet sur l'intensité du signal RPE en condition sèche. Les données des sondes fluorescentes de téréphtalate ont montré qu'en conditions humides, l'irradiation des cheveux blancs avec des UVA produisait d'importantes quantités de radicaux hydroxyles. Le traitement préalable des cheveux par N-acétylcystéine a réduit le nombre de radicaux hydroxyles produits par les cheveux blancs naturels comparé à un témoin non traité. Contrairement au résultat de la RPE, les cheveux blancs dopés avec des ions de cuivre ont produit des concentrations beaucoup plus élevées de radicaux hydroxyles en conditions humides. Il apparaît que la capacité des ions de cuivre à catalyser les radicaux libres photogénérés dans les cheveux dépend fortement de la teneur en eau. Les données relatives au photojaunissement ont démontré un avantage pour l'acide oxalique, aucune différence pour la N-acétylcystéine et une augmentation du jaunissement pour l'EDTA. CONCLUSION: Les méthodes de sonde fluorescente micro-RPE et téréphtalate sont deux techniques efficaces d'étude de la production de radicaux libres sur les cheveux exposés aux rayons ultraviolets en conditions humides et sèches, respectivement. Les deux tests sont des méthodes simples pour déterminer l'efficacité d'éventuels traitements de protection contre les dommages causés par les UV, mais étant donné qu'ils évaluent les dommages causés par les radicaux libres dans des conditions sèches ou humides, la réaction chimique créée lors de l'exposition aux UV est différente. Cela permet de mieux comprendre le mécanisme d'action, mais les résultats peuvent ne pas être cohérents entre les deux méthodes en raison des substances actives ajoutées pour réduire les dommages causés par les UV. Le traitement préalable par N-acétylcystéine a réduit la génération de radicaux libres dans les cheveux exposés aux UV en conditions humides et sèches. Les données de photojaunissement sont plus complexes, étant donné qu'il s'agit d'une mesure moins directe des dommages causés par les UV et qu'elles dépendent fortement de la source d'irradiation. L'utilisation de l'irradiation aux UVB est convenable d'un point de vue expérimental, mais peut ne pas être appropriée, car les longueurs d'onde UVB ne représentent que 0,3 % du rayonnement solaire terrestre. La photochimie de cheveux exposés à la lumière du soleil implique des processus de photoblanchiment et de photojaunissement concomitants, et est bien plus complexe. Dans des conditions d'irradiation aux UVB, l'acide oxalique a présenté un avantage en matière de jaunissement.

Laser hair reduction for hidradenitis suppurativa warrants insurance coverage.

Hidradenitis suppurativa is a chronic, painful disease that significantly reduces quality of life. Laser hair reduction is one modality that can be used in combination with other treatments to ameliorate the condition. We argue that insurance should provide coverage for this necessary service.

Chemical and physical treatments damage Caucasian and Afro-ethnic hair fibre: analytical and image assays.

BACKGROUND: Sensory and structural characteristics of hair can be modified by chemical and physical treatments, as dyeing, brushing, but also by external factors, as sunlight radiation. However, quantitative data relating damage to the degree of hair curliness and treatments are missing. OBJECTIVE: To evaluate the effect of chemical and physical treatments on different types of hair. METHODS: In this study, we compared the effects of bleaching/dyeing, thioglycolate-based straightening, brushing/flat iron and UVA/Vis radiation on different types of hair: Caucasian (straight dark brown, straight blond, wavy dark brown and curly dark brown) and Afro-ethnic hair. RESULTS: Bleaching/dyeing and UVA/Vis radiation increased combing work of Afro-ethnic hair tresses, indicating damage to the cuticle scales, which was confirmed by SEM images. Further, bleaching/dyeing caused wear on cuticles with high protein loss and reduction on the tryptophan content, independently of the hair curliness, which characterizes those procedures as very aggressive to hair structure. Straightening using ammonium thioglycolate, due to the oxidative treatment evolved, caused significant colour fading in brown/black tresses, while UVA/Vis radiation affected the colour of only blond hair tresses since they are poor in eumelanin, the photoprotective and photostable melanin molecule. CONCLUSION: The combination of analytical and image techniques contributed to understanding how the hair shape is related to the type of damage caused by several chemical and physical treatments. These findings contribute to the development of safety cosmetics that insure the beauty of curly hair, both Caucasian and Afro-ethnic hair.

Low-level laser therapy for the treatment of androgenetic alopecia in Thai men and women: a 24-week, randomized, double-blind, sham device-controlled trial.

Low-level laser/light therapy (LLLT) has been increasingly used for promoting hair growth in androgenetic alopecia (AGA). Our institute developed a new home-use LLLT device, RAMACAP, with optimal penetrating energy, aiming to improve therapeutic efficacy and compliance. To evaluate the efficacy and safety of the new helmet-type LLLT device in the treatment of AGA, a 24-week, prospective, randomized, double-blind, sham device-controlled clinical trial was conducted. Forty subjects with AGA (20 men and 20 women) were randomized to treat with a laser helmet (RAMACAP) or a sham helmet in the home-based setting for 24 weeks. Hair density, hair diameter, and adverse events were evaluated at baseline and at weeks 8, 16, and 24. Global photographic assessment for hair regrowth after 24 weeks of treatment was performed by investigators and subjects. Thirty-six subjects (19 in the laser group and 17 in the sham group) completed the study. At week 24, the laser helmet was significantly superior to the sham device for increasing hair density and hair diameter (p = 0.002 and p = 0.009, respectively) and showed a significantly greater improvement in global photographic assessment by investigators and subjects. Reported side effects included temporary hair shedding and scalp pruritus. In conclusion, the novel helmet-type LLLT device appears to be an effective treatment option for AGA in both male and female patients with minimal adverse effects. However, the limitations of this study are small sample size, no long-term follow-up data, and use of inappropriate sham devices, which do not reflect the true negative control. Trial registration: http://clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=2061 , identifier TCTR20160910003.

A randomized, investigator-blinded, controlled, split-scalp study of the efficacy and safety of a 1550-nm fractional erbium-glass laser, used in combination with topical 5% minoxidil versus 5% minoxidil alone, for the treatment of androgenetic alopecia.

Fractional 1550-nm erbium-glass (Er:Glass) laser therapy is effective in inducing hair regrowth. Combining fractional Er:Glass laser therapy with topical minoxidil may yield therapeutic benefits for patients with androgenetic alopecia (AGA). To compare the efficacy and safety of fractional Er:Glass laser used in combination with topical 5% minoxidil versus 5% minoxidil alone for the treatment of male AGA, 30 men with AGA were randomized to 24 weeks of split-scalp treatment using fractional Er:Glass laser and 5% minoxidil on one side (combined therapy) or 5% minoxidil alone on the other side (monotherapy). The primary outcome was the difference in hair density and diameter, from baseline, between two treatment sides, at week 24. The secondary outcome was a global photographic assessment, evaluated by two dermatologists and the participants. Adverse events were evaluated. Twenty-nine participants completed the 24-week study period. Combination therapy provided significantly superior results for both the primary and secondary outcomes (all p < 0.05). No serious adverse events were identified for either treatment. In conclusion, combination therapy, consisting of fractional Er:Glass laser and topical minoxidil, is a promising treatment option for AGA. Laser-induced photothermolysis and the formation of effective routes for transdermal drug delivery are possible mechanisms. clinicaltrials.in.th, identifier TCTR20160912001.

Transepidermal UV radiation of scalp skin ex vivo induces hair follicle damage that is alleviated by the topical treatment with caffeine.

OBJECTIVES: Although the effect of ultraviolet radiation (UVR) on human skin has been extensively studied, very little is known on how UVR impacts on hair follicle (HF) homeostasis. Here, we investigated how solar spectrum UVR that hits the human skin surface impacts on HF biology, and whether any detrimental effects can be mitigated by a widely used cosmetic and nutraceutical ingredient, caffeine. METHODS: Human scalp skin with terminal HFs was irradiated transepidermally ex vivo using either 10 J/cm2 UVA (340-440 nm) + 20 mJ/cm2 UVB (290-320 nm) (low dose) or 50 J/cm2 UVA + 50 mJ/cm2 UVB (high dose) and organ-cultured under serum-free conditions for 1 or 3 days. 0.1% caffeine (5.15 mmol/L) was topically applied for 3 days prior to UV exposure with 40 J/cm2 UVA + 40 mJ/cm2 UVB and for 3 days after UVR. The effects on various toxicity and vitality read-out parameters were measured in defined skin and HF compartments. RESULTS: Consistent with previous results, transepidermal UVR exerted skin cytotoxicity and epidermal damage. Treatment with high and/or low UVA+UVB doses also induced oxidative DNA damage and cytotoxicity in human HFs. In addition, it decreased proliferation and promoted apoptosis of HF outer root sheath (ORS) and hair matrix (HM) keratinocytes, stimulated catagen development, differentially regulated the expression of HF growth factors, and induced perifollicular mast cell degranulation. UVR-mediated HF damage was more severe after irradiation with high UVR dose and reached also proximal HF compartments. The topical application of 0.1% caffeine did not induce skin or HF cytotoxicity and stimulated the expression of IGF-1 in the proximal HF ORS. However, it promoted keratinocyte apoptosis in selected HF compartments. Moreover, caffeine provided protection towards UVR-mediated HF cytotoxicity and dystrophy, keratinocyte apoptosis, and tendential up-regulation of the catagen-promoting growth factor. CONCLUSION: Our study highlights the clinical relevance of our scalp UV irradiation ex vivo assay and provides the first evidence that transepidermal UV radiation negatively affects important human HF functions. This suggests that it is a sensible prophylactic strategy to integrate agents such as caffeine that can act as HF photoprotectants into sun-protective cosmeceutical and nutraceutical formulations.

OBJECTIFS: Alors que l'effet de rayons ultraviolets (RUV) sur la peau humaine a été largement étudié, on sait très peu de choses de l'impact des UV sur l'homéostasie du follicule pileux (FP). Ici, nous avons étudié l'effet du spectre des RUV solaires qui atteignent la surface de la peau humaine sur la biologie du FP, et si tout effet nocif peut être atténué par de la caféine, un ingrédient cosmétique et neutraceutique largement utilisé. MÉTHODES: Une peau de cuir chevelu humain avec ses FP terminaux a été irradiée ex vivo via l'épiderme soit par 10 J/cm2 d'UVA (340-440 nm) + 20 mJ/cm2 d'UVB (290-320 nm) (dose faible) soit par 50 J/cm2 d'UVA + 50 mJ/cm2 d'UVB (dose élevée) et placée en culture sans sérum pendant 1 ou 3 jours. 0,1% (5,15 mM) de caféine a été appliquée par voie topique pendant 3 jours avant l'exposition aux UV à raison de 40 J/cm2 d'UVA + 40 mJ/cm2 UVB et pendant 3 jours après l'exposition aux RUV. Les effets sur divers paramètres de toxicité et de vitalité ont été mesurés au niveau de compartiments définis de la peau et des FP. RÉSULTATS: Cohérent avec les résultats précédents, les RUV transépidermique ont exercé une cytotoxicité au niveau de la peau et des lésions épidermiques. Le traitement par des doses élevées et/ou faibles d'UVA+UVB a également induit des lésions oxydatives de l'ADN et une cytotoxicité au niveau des FP humains. En outre, il a diminué la prolifération et favorisé l'apoptose de la gaine externe de la racine (ORS) du FP et des kératinocytes de la matrice des cheveux (MC), a stimulé le développement de la phase catagène, a régulé de manière différentielle l'expression des facteurs de croissance des FP, et induit une dégranulation périfolliculaire des mastocytes. Les lésions du FP médiées par les RUV étaient plus graves après une irradiation par dose élevée de RUV et atteignaient également les compartiments proximaux du FP. L'application topique de 0,1 % de caféine n'a pas induit de cytotoxicité de la peau ou du FP et a stimulé l'expression d'IGF-1 dans la partie proximale de l'ORS du FP. Cependant, elle a promu l'apoptose des kératinocytes dans certains compartiments de FP. En outre, la caféine a fourni une protection des FP contre la cytotoxicité et la dystrophie médiées par les RUV, l'apoptose des kératinocytes et une régulation à tendance positive de l'effet catagène induit par le facteur de croissance. CONCLUSION: Notre étude souligne la pertinence clinique de notre dosage d'irradiation UV ex vivo du cuir chevelu et fournit la première preuve que le rayonnement UV transépidermique affecte négativement d'importantes fonctions du FP chez l'homme. Cela suggère que l'intégration d'agents photoprotecteurs des FP tels que la caféine dans les formulations cosmétiques et nutraceutiques des écrans solaires pourrait constituer une stratégie prophylactique sensée.

Clinical evaluation of a novel fractional radiofrequency device for hair growth: Fractional radiofrequency for hair growth stimulation.

AGA is a common disorder. Different treatments are available to prevent hair loss and achieve hair growth with variable results. The purpose of the present study was to evaluate the efficacy and safety of a novel fractional radiofrequency (RF) device (HairLux, Innogen Technologies Ltd., Yokneam, Israel), to prevent hair loss and induce hair growth. Twenty-five patients received 10 fractional RF treatments every 2 weeks, and were followed up 2 months after the last treatment. All patients were evaluated by global photography. In 10 patients, blinded manual hair counts were performed. Patients demonstrated less hair shedding, fuller hair, and faster hair growth. There was an average increase of 31.6% in hair density (based on hair counts) and 18% increase in hair shaft thickness. All subjects tolerated the treatments well. The HairLux device is effective and safe for hair growth stimulation in AGA. Ten treatment sessions are recommended to maximize results.

Infrared thermography as control of handheld IPL device for home-use.

Infrared thermography as contactless method for determining the temperature distribution on the surface is used for analyzing the impact of intense pulsed light hair removal device (IPL) on the skin. Depth of light penetration depending of wavelength is described as well as absorption curves and IPL impulse shapes. Energy balance and IPL impulse influence on the skin is analyzed. Melanin temperature rise by different fluence operation and temperature distribution in the modeled hair is used in order to determine overall skin temperature rise. Estimated energy balance provided by mathematical model has been confirmed with experimental results. Performed measurements, beside determination of the right emissivity, required the identification of most significant parameter in the process which proved to be the skin reference temperature and real temperature rise. Practical IPL application with detailed body temperature analysis is comprehensively described and thermal imaging interpretation problem and determination of the temperature rise is observed.

Systematic review of low-level laser therapy for adult androgenic alopecia.

Alopecia is a common disorder affecting over half of the world's population. Within this condition, androgenic alopecia (AA) is the most common type, affecting 50% of males over 40 and 75% of females over 65. Anecdotal paradoxical hypertrichosis noted during laser epilation has generated interest in the possibility of using laser to stimulate hair growth. In this study, we aimed to critically appraise the application of low-level laser therapy for the treatment of AA in adults. A systematic review was performed on studies identified on Medline, EMBASE, Cochrane database, and clinicaltrials.org. Double-blinded randomized controlled trials were selected and analyzed quantitatively (meta-analysis) and qualitatively (quality of evidence, risk of bias). Low-level laser therapy appears to be a promising noninvasive treatment for AA in adults that is safe for self-administration in the home setting. Although shown to effectively stimulate hair growth when compared to sham devices, these results must be interpreted with caution. Further studies with larger samples, longer follow-up, and independent funding sources are necessary to determine the clinical effectiveness of this novel therapy.

Use of low-level laser therapy in treatment of the androgenic alopecia, the first systematic review.

Alopecia is a common disease affecting more than half of the world total number of people. Alopecia exists in different types, but one of the most common of these types is the Androgenic Alopecia which has affected approximately 51% of the total number of males ranging between the age bracket of 40 years and 75 years. This type of alopecia is more common in females who are above the age of 65 years and above. Despite this widespread effect, much has not been done regarding identifying the possible drugs for treating this disease. At present, there exist only two possible medications that have been scientifically approved to cure this disease, include finasteride and minoxidil. Also, another possible form of treatment has been the case of hair transplantation. Despite the new possible treatment options available for treatment of different types of hair loss, there is a need for the invention for more efficient management and treatment options that are less costly, environmentally friendly, and most importantly human consumption friendly. Due to the recent evaluation that low-level laser therapy stimulated hair growth. This systematic review and meta-analysis was to determine whether the use of low-level laser therapy is an effective therapy for treatment of the Androgenic alopecia and also to some degree we reviewed the level of the patient's satisfaction. Some earlier studies had shown that the use of low-level laser therapy stimulated the hair growth when mice were treated with chemotherapy which was induced by the alopecia and also the other type of alopecia called alopecia areata. The researchers hypothesized that the primary mechanism of treating Androgenic alopecia to be the stimulation of the epidermal stem cells which are in the hair follicle making them bulge and shift the follicles into the anagen phase.

Activation of Wnt/ß-catenin signaling is involved in hair growth-promoting effect of 655-nm red light and LED in in vitro culture model.

Activation of the Wnt/ß-catenin signaling pathway plays an important role in hair follicle morphogenesis and hair growth. Recently, low-level laser therapy (LLLT) was evaluated for stimulating hair growth in numerous clinical studies, in which 655-nm red light was found to be most effective and practical for stimulating hair growth. We evaluated whether 655-nm red light + light-emitting diode (LED) could promote human hair growth by activating Wnt/ß-catenin signaling. An in vitro culture of human hair follicles (HFs) was irradiated with different intensities of 655-nm red light + LED, 21 h7 (an inhibitor of ß-catenin), or both. Immunofluorescence staining was performed to assess the expression of ß-catenin, GSK3ß, p-GSK3ß, and Lef1 in the Wnt/ß-catenin signaling. The 655-nm red light + LED not only enhanced hair shaft elongation, but also reduced catagen transition in human hair follicle organ culture, with the greatest effectiveness observed at 5 min (0.839 J/cm2). Additionally, 655-nm red light + LED enhanced the expression of ß-catenin, p-GSK3ß, and Lef1, signaling molecules of the Wnt/ß-catenin pathway, in the hair matrix. Activation of Wnt/ß-catenin signaling is involved in hair growth-promoting effect of 655-nm red light and LED in vitro and therefore may serve as an alternative therapeutic option for alopecia.

Removal of unwanted hair: efficacy, tolerability, and safety of long-pulsed 755-nm alexandrite laser equipped with a sapphire handpiece.

Due to the difference in refraction coefficients between air and the corneal epithelium, irradiation of the skin with a light source can lead to reflection of the energy and its leakage to the skin causes epidermal injury. All of which decreases the efficacy of treatment. We evaluated cooling sapphire handpieces' efficacy in decreasing pain and epidermal injuries and enhancing the treatment outcome in laser hair removal. A total of 49 patients with Fitzpatrick skin types of II to IV were treated for laser hair removal on face, limbs, inguinal, and axillary areas with pulsed 755-nm alexandrite laser equipped with a sapphire handpiece and the cooling system. Hair counts were performed by two independent observers at the baseline and 3 months after the final treatment. A marked reduction in hair regrowth was noted 3 months after the final treatment in all body locations studied. Clinical hair reduction was observed and fully assessed. There were no serious side effects with an average pain score of 4.6 out of 40. The cooled sapphire cylinder tip has been shown to minimize epidermal injury and reduce the system energy leaks to the skin.