Hair Loss

The role of inflammation and immunity in the pathogenesis of androgenetic alopecia.

Magro CM, Rossi A, Poe J, Manhas-Bhutani S, Sadick N.

Abstract

Background: Female pattern hair loss affects many women; its pathogenetic basis has been held to be similar to men with common baldness. Objective: The objective of this study was to determine the role of immunity and inflammation in androgenetic alopecia in women and modulate therapy according to inflammatory and immunoreactant profiles. Materials and Methods: 52 women with pattern hair loss (AA) underwent scalp biopsies for microscopic assessment and immunofluroescent studies. In 18 patients, serologic assessment for antibodies to androgen receptor, estrogen receptor and cytokeratin 15 was conducted. Results: A lymphocytic folliculitis targeting the bulge epithelium was observed in many cases. Thirty-three of 52 female patients had significant deposits of IgM within the epidermal basement membrane zone typically accompanied by components of complement activation. The severity of changes light microscopically were more apparent in the positive immunoreactant group. Biopsies from men with male pattern hair loss showed a similar pattern of inflammation and immunoreactant deposition. Serologic assessment for antibodies to androgen receptor, estrogen receptor or cytokeratin 15 were negative. Combined modality therapy with minocycline and topical steroids along with red light produced consistent good results in the positive immunoreactant group compared to the negative immunoreactant group. Conclusion: A lymphocytic microfolliculitis targeting the bulge epithelium along with deposits of epithelial basement membrane zone immunoreactants are frequent findings in male pattern hairloss and could point toward an immunologically driven trigger. Cases showing a positive immunoreactant profile respond well to combined modality therapy compared to those with a negative result. J Drugs Dermatol. 2011;10(12):1404-1411.

Dr Proctor notes: There have long been reports that gensing extract has some hair loss treatment efficacy.

J Ethnopharmacol. 2011 Sep 21. [Epub ahead of print]

Fructus panax ginseng extract promotes hair regeneration in C57BL/6 mice.

Park S, Shin WS, Ho J.

Radix panax ginseng (Panax ginseng C.A. Meyer, Araliaceae, RPG) has been documented to possess hair growth activity and widely used to treat alopecia, while no report has been issued to date on the effect of Fructus panax ginseng (FPG) on hair regeneration.

MATERIALS AND METHODS:

To investigate the effects of FPG extract on the proliferation of human hair dermal papilla cells (DPCs) and on the promotion of hair regeneration in C57BL6 mice, cell proliferation was evaluated in cultured DPC by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) and measured the expressions of Bcl-2 and Bax by immunoblot assay. We also compared the effects of topical FPG extract (1 and 10mg/ml, 100ìl/d) with the effects of minoxidil as a positive control (5%, 100ìl/d) or vehicle control (30% ethanol) on the depilation-induced hair cycling in 7 week-old-C57BL/6 mice.

RESULTS:

FPG extract significantly increased the proliferation of DPCs in dose and time dependent manners (P<0.05, P<0.01 and P<0.001). FPG extract also enhanced Bcl-2 expression and decreased Bax expression compared with control (P<0.01). Moreover, significant elongations of anagen phase during hair cycle after application of FPG were evaluated by photographical and histological observations.

CONCLUSIONS:

FPG extract improves the cell proliferation of human DPCs through anti apoptotic activation. Topical administration of FPG extract might have hair regeneration activity for the treatment of hair loss.

Slightly edited for hair loss blog use

Dr Proctor sez: Some of our agents may work thru some of the these same pathways.

J Drugs Dermatol. 2011 Nov 1;10(11):1308-12.

Hair Regrowth Following a Wnt- and Follistatin Containing Treatment: Safety and Efficacy in a First-in-Man Phase 1 Clinical Trial.

Zimber MP, et al

Abstract

Research has shown the importance of follistatin, Wnt 7a, and wound healing growth factors on the stimulation of bulge cells and inter-follicular stem cells to induce hair growth. We have studied the effects of a bioengineered, non-recombinant, human cell-derived formulation, termed Hair Stimulating Complex (HSC), containing these factors to assess its hair growth activity in male pattern baldness. HSC showed in vitro Wnt activity and contained follistatin, KGF, and VEGF. The clinical study was a double-blind, placebo-controlled, randomized single site trial and was designed to evaluate safety of the HSC product and assess efficacy in stimulating hair growth. All 26 subjects tolerated the single, intradermal injection of HSC procedures well, and no signs of an adverse reaction were reported. Histopathological evaluation of the treatment site biopsies taken at 22 and 52 weeks post-treatment revealed no abnormal morphology, hamartomas, or other pathological responses. Trichoscan image analysis of HSC-treated sites at 12 and 52 weeks showed significant improvements in hair growth over the placebo. At the initial 12-week evaluation period, HSC-treated sites demonstrated an increase in hair shaft thickness (6.3%±2.5% vs. -0.63%±2.1%; P=0.046), thickness density (12.8%±4.5% vs. -0.2%±2.9%; P=0.028), and terminal hair density (20.6±4.9% vs. 4.4±4.9%; P=0.029). At one year, a statistically significant increase in total hair count (P=0.032) continued to be seen. These results demonstrate that a single intradermal administration of HSC improved hair growth in subjects with androgenetic alopecia and is a clinical substantiation of previous preclinical research with Wnts, follistatin, and other growth factors associated with wound healing and regeneration. J Drugs Dermatol. 2011;10(11):1308-1312.

Slightly edited for hair loss blog use.

Dr Proctor sez: To my knowledge, this potentially-serious eye problem does not happen when minoxidil is taken orally. So most likely, it is just coincidental. But I will keep my eye on it....

Cutan Ocul Toxicol. 2011 Sep 23

Central chorioretinopathy associated with topical use of minoxidil 2% for treatment of baldness.

Scarinci F, et al

Abstract

Purpose: Minoxidil is one of the drugs approved for the treatment of androgenetic alopecia or male pattern hair loss. This article presents a case of central serous chorioretinopathy after application of topical minoxidil solution. Methods: We examined a 37-year-old man who complained of a positive relative scotoma, metamorphopsia and impaired dark adaptation involving the right eye. The patient reported an 8 month history of daily topical use but denied previous treatment with other drugs. Dilated fundus examination of right eye revealed central swelling located over the macula. Optical coherence tomography showed the presence of subretinal fluid. Fluorescein angiography disclosed one focal hyperfluorescent spot in the foveal area with minimal pigmentary changes limitated to that area. The patient was diagnosed with central serous chorioretinopathy (CSC) potentially related to an 8 month topical minoxidil solution administration. One month after the drug was discontinued, normal findings were found upon reexamination. The patient reported no previous episode of CSC. Conclusion: Major systemic side effects from topical solution of minoxidil are rare. To our knowledge, this is the first reported case of a central serous chorioretinopathy associated with long-term use of this drug.

Hair loss hair loss treatment and hair regrowth

Traish, A. M., Hassani, J., Guay, A. T., Zitzmann, M. and Hansen, M. L. (2011), Adverse Side Effects of 5á-Reductase Inhibitors Therapy: Persistent Diminished Libido and Erectile Dysfunction and Depression in a Subset of Patients. The Journal of Sexual Medicine, 8: 872–884. doi: 10.1111/j.1743-6109.2010.02157.x

Introduction.5á-reductase inhibitors (5á-RIs), finasteride and dutasteride, have been approved for treatment of lower urinary tract symptoms, due to benign prostatic hyperplasia, with marked clinical efficacy. Finasteride is also approved for treatment of hair loss (androgenetic alopecia). Although the adverse side effects of these agents are thought to be minimal, the magnitude of adverse effects on sexual function, gynecomastia, depression, and quality of life remains ill-defined.

Aim.  The goal of this review is to discuss 5á-RIs therapy, the potential persistent side effects, and the possible mechanisms responsible for these undesirable effects.

Methods.  We examined data reported in various clinical studies from the available literature concerning the side effects of finasteride and dutasteride.

Main Outcome Measures.  Data reported in the literature were reviewed and discussed.

Results.  Prolonged adverse effects on sexual function such as erectile dysfunction and diminished libido are reported by a subset of men, raising the possibility of a causal relationship.

Conclusions.  We suggest discussion with patients on the potential sexual side effects of 5á-RIs before commencing therapy. Alternative therapies may be considered in the discussion, especially when treating androgenetic alopecia. Traish AM, Hassani J, Guay AT, Zitzmann M, and Hansen M. Adverse side effects of 5á-reductase inhibitors therapy: Persistent diminished libido and erectile dysfunction and depression in a subset of patients. J Sex Med 2011;8:872–844.

Dr Proctor sez: This is an interesting review on the potential side-effects of (e.g.) finasteride and dutasteride used for hair loss treatment

5á-Reductase inhibitor therapy: Should physicians be concerned with persistent diminished libido, erectile dysfunction and depression in a subset of patients?

Background: 5á-reductase inhibitors have been approved for treatment of androgenetic alopecia and benign prostatic hypertrophy (BPH) with marked clinical efficacy. The magnitude of adverse effects of these agents on sexual function and quality of life varies considerably among patients and remains in question. However, to what extent 5á-redctase inhibitor therapy adversely affects sexual function, depression and quality of life is yet to be addressed? More importantly, should physicians be concerned regarding these adverse effects, especially when treating benign conditions of androgenetic alopecia and BPH?

Abdulmaged M. Traish, John Hassani, Andre T. Guay, Michael Zitzmann, Michael L. Hansen
journal of men's health
October 2010 (Vol. 7, Issue 3, Page 307)

Dr Proctor sez: This is a very good general review of the literature on hair loss treatment with finasteride ( Propecia )

Evidence-Based Dermatology: Review Efficacy and Safety of Finasteride Therapy for Androgenetic Alopecia A Systematic Review

José Manuel Mella, MD; María Clara Perret, MD; Matías Manzotti, MD; Hugo Norberto Catalano, MD, PhD; Gordon Guyatt, MD, PhD

Arch Dermatol. 2010;146(10):1141-1150. doi:10.1001/archdermatol.2010.256

Context Androgenetic alopecia is the most common form of alopecia in men.

Objective To determine the efficacy and safety of finasteride therapy for patients with androgenetic alopecia.

Data Sources: MEDLINE, EMBASE, CINAHL, Cochrane Registers, and LILACS were searched for randomized controlled trials reported in any language that evaluated the efficacy and safety of finasteride therapy in comparison to treatment with placebo in adults with androgenetic alopecia.

Study Selection and Data Extraction: Two reviewers independently evaluated eligibility and collected the data, including assessment of methodological quality (Jadad score). Outcome measures included patient self-assessment, hair count, investigator clinical assessment, global photographic assessment, and adverse effects at short term (12 months) and long term (24 months). Heterogeneity was explored by testing a priori hypotheses.

Data Synthesis: Twelve studies fulfilled the eligibility criteria (3927 male patients), 10 of which demonstrated a Jadad score of 3 or more. The proportion of patients reporting an improvement in scalp hair was greater with finasteride therapy than with placebo treatment in the short term (relative risk [RR], 1.81 [95% confidence interval (CI), 1.42-2.32]; I2, 64%) and in the long term (RR, 1.71 [95% CI, 1.15-2.53]; I2, 16%); both results were considered to have moderate-quality evidence. The number needed to treat for 1 patient to perceive himself as improved was 5.6 (95% CI, 4.6-7.0) in the short term and 3.4 (95% CI, 2.6-5.1) in the long term. Moderate-quality evidence suggested that finasteride therapy increased the mean hair count from baseline in comparison to placebo treatment, expressed as a percentage of the initial count in each individual, at short term (mean difference [MD], 9.42% [95% CI, 7.95%-10.90%]; I2, 50%) and at long term (MD, 24.3% [95% CI, 17.92%-30.60%]; I2, 0%). Also, the proportion of patients reported as improved by investigator assessment was greater in the short term (RR, 1.80 [95% CI, 1.43-2.26]; number needed to treat, 3.7 [95% CI, 3.2-4.3]; I2, 82%) (moderate-quality evidence). Moderate-quality evidence suggested an increase in erectile dysfunction (RR, 2.22 [95% CI, 1.03-4.78]; I2, 1%; number needed to harm, 82.1 [95% CI, 56-231]) and a possible increase in the risk of any sexual disturbances (RR, 1.39 [95% CI, 0.99-1.95]; I2, 0%). The risk of discontinuing treatment because of sexual adverse effects was similar to that of placebo (RR, 0.88 [95% CI, 0.51-1.49]; I2, 5%) (moderate-quality evidence).

Conclusion: Moderate-quality evidence suggests that daily use of oral finasteride increases hair count and improves patient and investigator assessment of hair appearance, while increasing the risk of sexual dysfunction.

Dr Proctor notes: The relationship between iron deficiency and hair loss in women is still not very well worked out.

J Am Acad Dermatol. 2010 Sep 29.

Iron deficiency and diffuse nonscarring scalp alopecia in women: More pieces to the puzzle.
St Pierre SA, et al

Abstract
The relationship between nonscarring scalp alopecia ( hair loss ) in women and iron deficiency continues to be a subject of debate. We review the literature regarding the relationship between iron deficiency and nonscarring scalp alopecia and describe iron-dependent genes in the hair follicle bulge region that may be affected by iron deficiency. We conclude with a description of our approach to the diagnosis and treatment of nonscarring alopecia in women with low iron stores. Limitations include published studies with small numbers of patients, different study designs, and absence of randomized, controlled treatment protocols. Additional research regarding the potential role of iron during the normal hair cycle is needed, as is a well-designed clinical trial evaluating the effect of iron supplementation in iron-deficient women with nonscarring alopecia.

Copyright © 2009 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Edited for hair loss blod

Could azathioprine be considered as a therapeutic alternative in the treatment of alopecia areata? A pilot study

International Journal of Dermatology, 10/05/2010

Farshi S et al. – No significant statistical difference was observed with respect to gender before and after azathioprine treatment. Treatment with azathioprine as a systemic monotherapy clinically produces relevant improvement in moderate–to–severe hair loss due to alopecia areata. Generally azathioprine is a low–cost and well–tolerated drug and with controlled studies on larger number of patients, long–term efficacy and safety of this treatment should be investigated.

Edited for hair loss treatment blog

Dr Proctor: Being able to regrow and multiply hair follicles is an important step in the treatment of hair loss.

Regen Med. 2009;4:667

Hair follicle neogenesis induced by cultured human scalp dermal papilla cells.
Qiao J,-et al

AIM: To develop a method by which human hair follicle dermal papilla cells can be expanded in vitro while preserving their hair-regrowth potential for use in follicular cell implantation, a cellular therapy for the treatment of hair loss. ...snip..

RESULTS: ....( Hair follicle ) cultures from numerous donors reproducibly resulted in an expansion that averaged approximately five population doublings per passage. Furthermore, the cells consistently induced hair formation in an in vivo graft assay. Grafted DP cells appeared in DP structures of newly formed hairs, as well as in the dermal sheath and in the dermis surrounding follicles. Induced hair follicles persisted and regrew after being plucked 11 months after grafting. A process for the propagation of human DP cells has been developed that provides significant expansion of cells and maintenance of their hair-regrowth inductive capability, overcoming a major technical obstacle in the development of follicular cell implantation as a treatment for hair loss.

Edited for hair loss treatment blog use.

J Proteome Res. 2010 Aug 19.

Trichohyalin is a Potential Major Autoantigen in Human Alopecia Areata.
Leung MC, et al

Abstract
Several lines of evidence support an autoimmune basis for hair loss due to alopecia areata (AA), a common putative autoimmune hair loss disorder. However, definitive support is lacking largely because the identity of hair follicle (HF) autoantigen(s) involved in its pathogenesis remains unknown. Here, we isolated AA-reactive HF-specific antigens from normal human scalp anagen HF extracts by immunoprecipitation using serum antibodies from 10 AA patients. Samples were analyzed by LC-MALDI-TOF/TOF mass spectrometry, which indicated strong reactivity to the hair growth phase-specific structural protein trichohyalin in all AA sera. Keratin 16 (K16) was also identified as another potential AA-relevant target HF antigen. Double immunofluorescence studies using AA (and control sera) together with a monoclonal antibody to trichohyalin revealed that AA sera contained immunoreactivity that colocalized with trichohyalin in the growth phase-specific inner root sheath of HF. Furthermore, a partial colocalization of AA serum reactivity with anti-K16 antibody was observed in the outer root sheath of the HF. In summary, this study supports the involvement of an immune response to anagen-specific HFs antigens in AA and specifically suggests that an immune response to trichohyalin and K16 may have a role in the pathogenesis of the enigmatic disorder.

Modified for hair loss treatment blog

Hair Loss treatment at the Proctor Clinic

Try our patented formulas for better hair regrowth.

Am J Pathol. 2006 March; 168(3): 748–756.
doi: 10.2353/ajpath.2006.050468. PMCID: PMC1606541

Copyright © American Society for Investigative Pathology

Title: Human Scalp Hair Follicles Are Both a Target and a Source of Prolactin, which Serves as an Autocrine and/or Paracrine Promoter of Apoptosis-Driven Hair Follicle Regression

Kerstin Foitzik et al

From "discussion" section

" Here, we provide the first evidence that human scalp HFs not only express functional PRL-R but also serve as an important extrapituitary site of PRL expression on the gene and protein level (Figure 1, A–D, and Figure 4). Given that human skin has been calculated to display ~5 million HFs, this calls attention to a very substantial, newly identified source of potential PRL synthesis in humans. This deserves further scrutiny and characterization, eg, in healthy versus inflamed human skin, and definition of the quantity of HF-derived PRL that is actually secreted systemically and thus exerts genuine endocrine, rather than autocrine or paracrine activities.Although our finding of intracutaneous transcription of the PRL gene in human skin in situ is well in line with the previous finding of PRL transcription in murine skin in vivo and in human cultured dermal fibroblasts, keratinocytes, and sweat glands in vitro,36,39 it conflicts with the report of Slominski and colleagues40 who could not detect PRL mRNA in human skin by RT-PCR. In our experiments, we detected PRL transcripts of the expected length both in human full-thickness skin and in isolated human HFs, using pituitary gland as positive control, and confirmed our data by sequencing the PRL RT-PCR product. The negative PRL expression data of Slominski and colleagues40 may be related to the fact that these investigators studied sun-exposed truncal skin (containing primarily vellus HFs, approximately half of which are in the telogen stage of the hair cycle), whereas we analyzed scalp skin, which is unusually rich in very large terminal HFs, 80 to 90% of which are in anagen VI HF. In addition, we used different primer sequences and PCR conditions than these investigators, who may well have identified an alternatively spliced PRL mRNA variant that could not be detected because of the exonal location of their primers. The sense primer used by Slominski and colleagues40 was located in exon 3, and the anti-sense primer contained both the end of exon 4 sequences and the initial part of exon 5 sequences. In contrast, our sense primer is in exon 2 and anti-sense primer is in exon 4.PRL mRNA as well as PRL and PRL-R immunoreactivity can be detected within the same epithelial human HF compartments (Figure 1, A–D, and Figure 4), and culture of microdissected, denervated, and avascular HFs in the presence of exogenous PRL exerts significant growth-modulatory effects (Figure 1, E–H, and Figure 2, a and b). This supports the hypothesis that PRL acts in an autocrine and/or paracrine manner on locally expressed high-affinity receptors and functions as a catagen-promoting signal in human HFs just as it does in mouse HFs. The strictly epithelial immunoreactivity pattern of PRL and PRL-R identified here for human scalp HFs corresponds well to the one previously described in mice. However, in ovine HFs, PRL-R expression has also been detected in the dermal papilla. Thus, expression of PRL-R seems to be differentially regulated in seasonally dependent HFs (ovine) compared to seasonally independent HFs (mouse, human).Steroid hormones stimulate cognate receptors in the HF epithelium and mesenchyme and change the secretion of potent hair growth modulators such as TGF-â, which then act back on the epithelium. In contrast, the polypeptide hormone PRL seems capable of signaling more directly within the HF epithelium as an autocrine and/or paracrine promoter of apoptosis-driven HF regression. However, our currently available data do not allow us to exclude that the observed HF effects of PRL were mediated at least in part also indirectly. This could happen via the recognized effects of PRL on peripheral androgen27 and estrogen metabolism, and/or via induction of changes in the intrafollicular expression of PRL-sensitive growth factors, cytokines, and enzymes with recognized hair growth-modulatory functions,21 such as TGF-â1,55 vascular endothelial growth factor,2 IGF-2, interferon-ã, and ornithine decarboxylase.58Treatment of isolated human HFs in culture with PRL results in apoptosis-driven HF regression (catagen), decreased proliferation, and increased apoptosis of follicular keratinocytes (Figure 3). These data correspond well to the rapid, premature induction of apoptosis-driven catagen development in murine anagen skin organ culture22 and to the reported catagen induction by PRL in sheep in vivo. However, PRL has also been shown to exert anti-apoptotic functions, eg, in cultured human breast cancer cell lines in vitro, to act as a larval growth hormone and to be required for limb regeneration in amphibians.61 Therefore, the anti-proliferative and proapoptotic properties of PRL in HF epithelium may not extend to all epithelial-mesenchymal interaction systems and may be developmentally controlled.Although it remains to be clarified how PRL exerts its activities on human HFs, we show that PRL is a potent catagen-promoter of human HFs in vitro, with efficacy comparable to that of TGF-â2, yet is lower than that of interferon-ã. We also show that the catagen-promoting activity of PRL is independent of the hypothalamus-pituitary-adrenal axis and systemic hormone levels. It applies to HFs of a mammalian species with mosaic and seasonally independent HF cycling (=human scalp HF). PRL has long been recognized to play a role in hair growth control in seasonally dependent coat changes, because both rising and falling daily plasma PRL levels can induce moulting. The current human data fit well with the previous reports that PRL induces premature catagen in the, also seasonally independent, murine hair cycle22 and that murine PRL-R-null mutants show longer and coarser hair as well as hair cycle perturbations.23 The present data, therefore, underscore the importance of PRL as a hair growth modulator for both seasonally dependent and independent HF cycling across different mammalian species.PRL has also been implicated in the pathogenesis of androgenetic alopecia25 by modulation of androgens, and hyperprolactemia is associated with an androgenetic alopecia-type hair loss pattern, along with hirsutism (in females). Usually, occipital scalp HFs are insensitive to hormones such as androgens. In our experiments we used mostly occipital scalp HFs and additionally frontal HFs. It is therefore particularly interesting that PRL was able to induce catagen in these hormone-insensitive HFs. It is important to mention that PRL may have distinct functions on distinct areas of scalp and body HFs and that this will be an interesting issue to investigate in the future. Recently, it has been shown that neuroendocrine factors mediate stress-induced acne. HFs and the sebaceous glands express functional receptors for stress-related hormones, which are able to modulate androgen metabolism in the sebaceous gland. These up-regulated androgens in the sebaceous gland could also be involved in stress-induced hair loss. Therefore, it will be interesting to investigate whether PRL is able to modulate androgen receptor expression and/or androgen metabolism in the human pilosebaceous unit. In summary, our study shows that human anagen scalp HFs are very sensitive for inhibitory PRL-R-mediated signals. This is clinically relevant, because it provides a reasonable mechanism to explain the, as yet ill-understood, telogen effluvium associated with hyperprolactinemia.25 It also points to novel therapeutic strategies for the management of stress-related and hormonal hair loss in men and women, by use of recently developed PRL-R antagonists...."

Modified for baldness blog

Keywords: hair loss treatment hair regrowth balding minoxidil nano shampoo Dr Droctor tempol hair loss regrowth propecia proxiphen (tm).

Interesting paper on the role of prolactin in the hair cycle. One more thing that seems to drive the hair loss process. Dr Proctor

Am J Pathol. 2006 Mar;168(3):748-56.

Human scalp hair follicles are both a target and a source of prolactin, which serves as an autocrine and/or paracrine promoter of apoptosis-driven hair follicle regression.

Foitzik K, et al

Abstract
The prototypic pituitary hormone prolactin (PRL) exerts a wide variety of bioregulatory effects in mammals and is also found in extrapituitary sites, including murine skin. Here, we show by reverse transcriptase-polymerase chain reaction and immunohistology that, contrary to a previous report, human skin and normal human scalp hair follicles (HFs), in particular, express both PRL and PRL receptors (PRL-R) at the mRNA and protein level. PRL and PRL-R immunoreactivity can be detected in the epithelium of human anagen VI HFs, while the HF mesenchyme is negative. During the HF transformation from growth (anagen) to apoptosis-driven regression (catagen), PRL and PRL-R immunoreactivity appear up-regulated. Treatment of organ-cultured human scalp HFs with high-dose PRL (400 ng/ml) results in a significant inhibition of hair shaft elongation and premature catagen development, along with reduced proliferation and increased apoptosis of hair bulb keratinocytes (Ki-67/terminal dUTP nick-end labeling immunohistomorphometry). This shows that PRL receptors, expressed in HFs, are functional and that human skin and human scalp HFs are both direct targets and sources of PRL. Our data suggest that PRL acts as an autocrine hair regrowth modulator with catagen-promoting functions and that the hair growth-inhibitory effects of PRL demonstrated here may underlie the as yet ill-understood hair loss in patients with hyper-prolactinemia.

Modified for hair loss treatment blog use

Hair loss treatment at the Proctor clinic.