Patients with tinea capitis typically present with patchy alopecia with or without scaling, although the entire scalp may be involved. Other findings include adenopathy and pruritus. Children may have an associated kerion, a painful erythematous boggy plaque, often with purulent drainage and regional lymphadenopathy. Posterior auricular lymphadenopathy may help differentiate tinea capitis from other inflammatory causes of alopecia. If the diagnosis is not clear from the history and physical examination, a skin scraping taken from the active border of the inflamed patch in a potassium hydroxide preparation can be examined microscopically for the presence of hyphae. Skin scrapings can also be sent for fungal culture, but this is less helpful because the fungi can take up to six weeks to grow.

When it comes to organic products there are popular and high-quality brands you can choose from. Some chemicals can have quite harsh effects on longer hair, which means that they are not always suitable for women.  There are several organic brands that can be effective for those sensitive to these chemicals and in some cases can be more effective. Among the organic shampoos available are Reborn MAX and PhytoWorx.  Two brands that use caffeine are Apex Crown from Wick & Strom, and Ultrax Labs Hair Surge.

The best hair loss shampoos are gentle enough so that you can use them multiple times a week. Nizoral, however, is most effective when used only a few times a week (and should be left on the hair for three to five minutes before rinsing). But you can also alternate Nizoral with another type of hair loss shampoo – such as the Lipogaine products or Alpecin’s Caffeine shampoo – for an effective one-two hair loss fighting punch. Use Nizoral twice a week while using your other hair loss shampoo on the other days.
A diet that is poor or lacking in certain nutrients, particularly iron, protein, and vitamin B, which are essential in the production of keratin, can cause a long telogen phase and a very short anagen stage. On the other hand, excess supply of vitamin A in the body, especially those taken through supplements, can prove to be toxic and can cause a range of adverse body effects including loss of appetite, fatigue and consequently, hair loss.
Beyond that, things get more controversial, with some doctors saying there's inadequate evidence for other treatments. Saxena thinks there is enough scientific evidence to support some of the alternatives and recommends them to patients. But they are not for women on tight budgets. There's Nutrafol, a "nutraceutical" that costs about $80 a month. Women can also get injections in the scalp of platelet-rich plasma made from their own blood. The first four treatments cost about $2,000 at Saxena's practice in Fort Washington or Lansdale. Maintenance injections, done every three to six months, cost $515 each. Women can also buy Theradome, a light-emitting helmet, for $895 online.  Saxena, who has hair loss herself, said she has had the injections and currently uses minoxidil, spironolactone, and Nutrafol.
Cloning has seen many false starts and wrong turns, Christiano told me. Now her team is building “an artificial skin with a dermis and an epidermis, with molds made to mimic the dimensions of hair density,” she explained. “When the artificial skin matures we pull out the pre-formed hairs and insert them into the skin.” Bernstein is convinced that, in the next ten years, cloned hair will happen. “And then the supply and demand problem is solved,” Bernstein said. “Without Bernanke!”
How about if you’d rather not get your head punctured? In Sweden, a company called Follicum is now doing Phase IIA clinical studies and planning to communicate results by the end of the year. The end product will be a cream or a lotion, one that could be applied as few as three times a week. In the first trial, Follicum claims, more than seventy-five per cent of patients experienced hair growth. This is the real dream, the one so artfully captured in the Hims ads: pop a pill, slap on some cream, and get Hair God locks.
Some 30 million women in the United States have hereditary hair loss (compared with 50 million men), according to the American Academy of Dermatology, though that figure does not include the millions more who struggle with thinning hair because of pregnancy, menopause, stress and other health conditions. Barely 5 percent of women are said to be good candidates for hair transplant surgery because women lose hair everywhere, meaning that, unlike with men, there is rarely a luxuriant spot on the back of the head from which to harvest hairs unobtrusively.
Hair practices. Our hair is one of the strongest and most elastic parts of our body. One strand of a healthy hair can be twice as strong as a copper wire of similar thickness. However, not all hair types are equal. Unfortunately, hair care practices and styling can lead to scalp damage and unnecessary pressure on the hair follicles, resulting in hair breakage and loss.
Dr. Melissa Piliang, a dermatologist at the Cleveland Clinic, said that Rogaine works better on the top and crown (for reasons not fully understood, the frontal hairline tends to be more resistant to treatment) and ideally should be started as soon as women notice thinning. “Any regrowth you get is a minimal amount,” Dr. Piliang said. “So the more density when you start, the better results you get.”
You always hear these stories about people who take a homeopathic approach to fighting baldness. It’s always some off-the-wall remedy like smearing a paste of ginger and cayenne pepper on your scalp three times a day or eating a special type of ginseng farmed only in a rural village in Tibet. We'll go on the record to say that it's highly unlikely that these remedies work at any level. 

Yesterday marked the “estimated study completion date” for setipiprant’s phase 2a trial in androgenetic alopecia in males. The participants of the trial received 1000 mg of setipiprant by oral tablets twice a day over a 6 month period. I expect the results to be presented sometime in 2nd half 2018. Here’s to hoping for positive results from this trial and expediency in beginning a phase 2b or phase 3 trial for setipiprant. Clinical trial page here.
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“Smelling” Receptor Keeps Hair Growing – Many of you may have noticed the headlines regarding sandalwood and hair growth over the past week. The research everyone is talking about comes from Ralf Paus and his team at the Monasterium Laboratory GmbH. For the record, Paus is also the main researcher behind the WAY-316606 hair growth discovery. This time Paus et al identified an olfactory receptor in hair follicles, OR2AT4,  which plays a role in regulating hair growth or inhibition. Olfacory receptors are responsible for detecting odors in cell membranes and provide the basis for our sense of smell, they do carry out additional functions though, as demonstrated by Paus. 
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I wonder whether hair loss would get as much attention if it were primarily suffered by women. But Kobren corrects me. “Actually, 40% of hair loss sufferers are women,” he says. “Except women are able to wear wigs and hair extensions and they can camouflage it in a way that men aren’t really allowed to.” He describes female pattern hair loss as a “silent epidemic of biblical proportions” that he puts down to the use of cosmetics and birth control (some women experience hair loss as a side effect to contraceptive pills).
RepliCel is a regenerative medicine company focused on developing autologous cell therapies (or therapies that involve one individual as both donor and recipient) that address conditions linked to a deficit of healthy cells required for normal healing and function. Located in Vancouver, British Columbia, the company has developed first-of-their-kind cell therapies that will, they hope, treat conditions that now affect 1 in 3 Americans: pattern baldness, aging and sun-damaged skin, and chronic tendon degeneration.
Key features: The Thick & full Hair Growth Set by DermaChange is a go-to option for hair loss and thinning strands — it's chock-full of vitamins and oils that promote hair regrowth and prevent hair loss by hydrating, strengthening, and thickening strands with natural ingredients. It's also made with a gentle, sulfate-free formula, so it's a safe choice for color-treated hair and sensitive scalps.
Many other women, though, start noticing thinning hair on top of their heads. Doctors say the defining sign is a widening of the part. The hairline itself is usually intact, but the hair becomes less dense behind it. Doctors will often run a battery of tests to make sure there are no treatable medical conditions, such as anemia, thyroid problems, tumors, or hormonal problems. "Ninety percent of the time, it's normal," Patel said.
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.
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