Relieving postoperative pain using tumescent solution with ropivacaine in follicular unit excision.

BACKGROUND: Local tumescent anesthesia relieves postoperative pain. OBJECTIVE: The objective of the study was to compare the effect of injecting a tumescent solution with/without ropivacaine on postoperative pain. METHODS: A randomized, double-blind control study was conducted in 314 patients who underwent first follicular unit excision after obtaining informed consent and ethics committee approval. The patients were randomly divided into three groups: intra-groups (group 1, injected with tumescent solution with ropivacaine; group 2, without ropivacaine) and inter-group (group 3, right-head/left-head side with/without ropivacaine). Postoperative pain was recorded using the 5-point Wong-Baker Faces Pain Scale. No preoperative analgesic was administered to any patient. The survival rate of hair follicles was measured using dermoscopy during follow-up. Data were statistically analyzed. RESULTS: Of the 314 patients included in the study, 166 were men and 148 were women with a mean age of 32.15 ± 4.58 (range, 25-45) years. Postoperative pain with ropivacaine was significantly more relieved compared with that without ropivacaine in both groups (p < 0.05). There was no significant difference between sex and survival rate of hair follicles in the intra- or inter-group. CONCLUSION: A tumescent solution with ropivacaine has proven to relieve postoperative pain and is a safe and valuable form of local anesthesia in follicular unit excision.

The effect of hyperbaric oxygen therapy combined with hair transplantation surgery for the treatment of alopecia.

BACKGROUND: Transplanted hair follicles suffer from various injuries, which are difficult to prevent. Hyperbaric oxygen therapy (HBOT) was reported to be an excellent procedure to promote capillary regeneration and reduce ischemia-reperfusion injury. AIM: To evaluate the clinical efficacy of HBOT as an adjuvant therapy for hair transplantation surgery. METHODS: Thirty-four patients with II-IV alopecia were divided into the control group and HBOT group randomly. The control group was treated with routine FUE procedure, while HBOT group combined with HBOT. Patients were treated with 100% oxygen under 2.0 atmospheres absolute pressure for 60 minutes through a facemask during HBOT and take the therapy daily for 7 days continuously after operation. Satisfaction and clinical improvement were evaluated at the fourth week and the sixth month postoperatively. RESULTS: Itching and folliculitis were significantly decreased in HBOT group (11.8% vs 35.3%). In addition, HBOT resulted in a lower postoperative shedding rate (27.6 ± 2.6% vs 69.1 ± 2.4%); nevertheless, the survival rate at 9 months showed no significant difference between HBOT (96.9 ± 0.5%) and control (93.8 ± 0.6%). The early postoperative satisfaction in control group was much lower than HBOT group (52.9% vs 88.2%), whereas all patients showed satisfaction with the final result. CONCLUSION: Hyperbaric oxygen therapy is able to minimize the postsurgical follicle shedding and lead to less folliculitis and itching, which provides evidence for HBOT to act as an adjuvant therapy for hair transplantation surgery.

Comparison of low-level light therapy and combination therapy of 5% minoxidil in the treatment of female pattern hair loss.

This study was conducted in order to compare the safety and efficacy of LLLT, 5% minoxidil, and combination therapy in the treatment of FPHL. A randomized controlled trial was developed to study the effect of LLLT on FPHL using a device called iHelmet®, which is equipped with 200 5mW laser diode source (650 nm) arrays. Ninety Ludwig's types II-III FPHL patients were randomly divided into 3 groups: LLLT group (A), 5% minoxidil group (B), and combination group(C). Hair density, hair diameter, and scalp oil-secretion were detected to evaluate the treatment effect. Significant improvement of hair density and hair diameter was observed in all stages of FPHL after treatment. Oil-secretion of the three groups was decreased after treatment. The effectiveness of reducing oil-secretion in LLLT group and combination group was higher than minoxidil group (P < 0.05). For improving hair diameter and hair density, combination group was better than LLLT and minoxidil groups. No side effects were reported. Our study illustrated that LLLT is a safe and effective treatment for FPHL. Besides, LLLT can significantly improve its efficacy when used in combination with 5% minoxidil.

Comparison of pulsed dye laser (PDL) and photodynamic therapy (PDT) for treatment of facial port-wine stain (PWS) birthmarks in pediatric patients.

BACKGROUND: Vascular-acting photodynamic therapy (PDT) might be an alternative approach for treating port wine stain (PWS) birthmarks, but the usefulness of PDT for pediatric patients has not been fully investigated. STUDY DESIGN: Medical records of pediatric patients (3-10 years old) with red and purple facial PWS were analyzed. Clinical outcomes after one session of PDL (585 nm, 4.8-6.5 J/cm(2)) and PDT (Hemoporfin - 3.5mg/kg, copper vapour laser - 120 J/cm(2)) were compared. RESULTS: The rate of excellent response in PDT group was significantly higher than that in PDL group (25.0% vs 10.9%). For red lesions there was no significant difference in overall response between PDL and PDT group, but for purple lesions the overall response rate of PDT group was significantly higher than that of PDL group (93.0% vs 75.6%). Lesions located at the forehead, cheek and jaw regions showed better responses to PDT. Incidences of pigmentation and scar formation in PDT group were significantly lower than PDL group (8.3% vs 21.1%). CONCLUSION: This study suggests that PDT is safe and effective for treating facial PWS of childhood patients.

[Inhibition effect of 6-gingerol on hair growth].

OBJECTIVE: To investigate the effect of 6-gingerol, the main active component of ginger, on hair shaft elongation in vitro and hair growth in vivo. METHODS: Firstly, Hair follicles were co-cultured with 3 different concentration of 6-gingerol for 5 days and hair elongation in three groups was measured. Secondly, The proliferative effect of 6-gingerol on DPCs was measured using MTT assay. Thirdly, the expression of Bcl-2 and Bax in DPCs were measured using Western blotting. In vivo study, the influence of 6-gingerol on hair growth in C57BL/6 rats was measured through topical application of 6-gingerol on the dorsal skin of each animal. RESULTS: The length of hair shaft in 20 microg/ml 6-Gingerol group (0.50 +/- 0.08 mm) is less than 0 microg/ml (0.66 +/- 0.19) mm and 10 microg/ml (0.64 +/- 0.03) mm 6-Gingerol group (P < 0.05). In cell culture, compared to 0 microg/ml and 5 microg/ml 6-Gingerol, 10 microg/ml 6-Gingerol can significantly inhibited the proliferation of DPCs (P < 0.05). Along with the growth inhibition of DPCs by 6-gingerol, the Bax/Bcl-2 ratio increased obviously. In vivo study, the hair length and density decreased a lot after using 1 mg/ml 6-gingerol. CONCLUSIONS: 6-Gingerol can suppress human hair shaft elongation because it has pro-apoptotic effects on DPCs via increasing Bax/Bcl-2 ratio. It might inhibit hair growth by prolonging the telogen stage in vivo.