The physical examination should focus on the hair and scalp, but attention should be given to physical signs of any comorbid disease indicated by the review of systems. If only the scalp is involved, the physician should look for typical male or female pattern to determine the presence of androgenetic alopecia. Whole body hair loss is consistent with alopecia totalis. Dry, broken hair suggests trichorrhexis nodosa, whereas scaling, pustules, crusts, erosions, or erythema and local adenopathy suggest infection.
Patients with hair loss will often consult their family physician first. Hair loss is not life threatening, but it is distressing and significantly affects the patient's quality of life. The pattern of hair loss may be obvious, such as the bald patches that occur in alopecia areata, or more subtle, such as the diffuse hair loss that occurs in telogen effluvium. As with most conditions, the physician should begin the evaluation with a detailed history and physical examination. It is helpful to determine whether the hair loss is nonscarring (also called noncicatricial), which is reversible, or scarring (also called cicatricial), which is permanent. Scarring alopecia is rare and has various etiologies, including autoimmune diseases such as discoid lupus erythematosus. If the follicular orifices are absent, the alopecia is probably scarring; these patients should be referred to a dermatologist. This article will discuss approaches to nonscarring causes of alopecia.

I’ve been updating the Ultimate Guide to Hair Regeneration 2018 a bit over the last several weeks. There are two new companies who made the list, although you’ve most likely heard of them before, and some positions have changed. Position changes usually happen when pivotal news gets reported or progress is made by a particular company. I’ve been meaning to work on the Guide for a while now and only recently found time for it in between writing new articles and other activities. 


Laser treatments. Low-level laser therapy (LLLT) is used for the prevention and reversal of hair loss. Also known as red light therapy, cold laser, and soft laser, it is a form of light/heat treatment (therefore generally safer) that is used on cases of pattern baldness and alopecia areata. The procedure uses a device that emits light that penetrates into the scalp. The more commonly used lasers are the excimer, helium-neon and fractional erbium-glass. The procedure can increase the blood flow in the scalp to stimulate the follicles that are in resting or dormant phase to go into anagen, and at the same time, prevent the production of DHT, which destroys the hair follicles.
Lately I’ve been receiving a few inquiries from readers about Shiseido and Brotzu release dates. So, I’m going to address the situation here and hope that this will be sufficient until more news comes from direct sources. I estimate that these companies would publicly address the release date of their products by the end of Q3 this year (end of Sept). As consumers we know there’s no guarantees for releases and if one or both of these products reached the market this year it would be a very fortunate situation. So, keep an eye out, but loosen the grip a little. The news will come when it comes. When there is news it will be visible here.
decrease in your blood Prostate Specific Antigen (PSA) levels. Finasteride can affect a blood test called PSA (Prostate-Specific Antigen) for the screening of prostate cancer. If you have a PSA test done you should tell your healthcare provider that you are taking Finasteride because Finasteride decreases PSA levels. Changes in PSA levels will need to be evaluated by your healthcare provider. Any increase in follow-up PSA levels from their lowest point may signal the presence of prostate cancer and should be evaluated, even if the test results are still within the normal range for men not taking Finasteride. You should also tell your healthcare provider if you have not been taking Finasteride as prescribed because this may affect the PSA test results. For more information, talk to your healthcare provider.
This is a short-term cure, applied while waiting for hair to grow, and therefore recommended for those with a mild to medium case of hair loss. In addition to being non-invasive, hair concealers and hair fibers are instant and affordable. Like wigs and hairpieces, they are used to effectively cover up balding spots while not getting in the way of growing hair. Compared to wigs, however, they are more natural looking and blend well with your natural hair, therefore drawing less attention when you're out in public.
Dupilumab is FDA approved for treating eczema aka atopic dermatitis and sold under the brand name Dupixent.  As the story goes, a patient with alopecia totalis (a form of areata which leaves a person’s head completely bald) was being treated for eczema by the drug Dupixent. After 6 weeks the patient first began to notice progress in terms of hair growth and at 7 months she had noticeable pigmented hair growth on her scalp. Notably, the patient stopped taking the dupilumab for a period of time and noticed her growth subsided; when she began taking the drug again the hair improved once more. This provides another useful therapy option for patients seeking treatment for AA. One would imagine a topical version would be worthwhile to investigate.
After the robot was done, two nurses picked off the skin grafts and hairs and put them in petri dishes. While they prepared them for implantation, Bernstein explained the real future of the business: cloning. Bernstein has partnered with a Columbia University geneticist, Angela Christiano, who is working on duplicating hairs. The problem with hair transplantation is that you’re moving hairs around, not creating new ones. Women affected by female-pattern hair loss, in particular, are left out: they don’t have a thick back patch of “donor hair” to work with.

In February, though, Ms. Telford, 46, flew from her home in London, Ontario, to Sarasota, Fla., for a new $1,400 hourlong treatment known as platelet rich plasma (P.R.P.), which is said to stimulate dormant hair follicles. The procedure involves drawing blood, spinning it in a centrifuge to extract the plasma, adding various nutrients (like more protein), then injecting the resulting mixture in one-inch intervals in a grid on the top of the scalp, which has been numbed with a local anesthetic.
While it’s not entirely clear why hair growth occurred after taking dupilumab, Senna hypothesizes that dupilumab may alter the immune system pathway that is overactive in eczema sufferers. "Right now, it's hard to know whether dupilumab could induce hair growth in other alopecia patients, but I suspect it may be helpful in patients with extensive active eczema and active alopecia areata," she explained.
Two clinical trials have been ran as a proof of concept for Histogen. Terminal hair count and hair thickness noticeably increased after just 12 weeks. Due to this success, Histogen plans to conduct a Phase 1 Clinical Study in the United States. This will be an injectable which when injected into the scalp will stimulate dormant hair follicles and induce new hair follicle formation (think Botox but for hair follicles instead of skin cells). HSC660 is an ongoing female hair loss trial that will run for 22 weeks and a late stage (Phase 3 trial) for men has initiated in Mexico. Histogen founder Gail Naughton even went so far to reveal commercialization, “We’e in very late-stage negotiations with some huge retail partners,” she says. It may not be a magic bullet, but it would sure be nice to have an alternative/supplement to Rogaine that actually stimulates growth.
Because there are a lot of products in the crowded marketplace that claim they can regrow your hair, it’s a necessity for the legitimate ones to have disclaimers on their websites. Essentially, these disclaimers state that the products haven’t been evaluated by the FDA and so can’t be guaranteed to provide the benefits they claim to provide—at least not from the standpoint of the regulators.
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