Hair & Nails

A marine protein–based oral food supplement was safe and associated with significant hair growth in women with self-perceived thinning hair, according to findings from a small randomized controlled, double-blind study.

The mean number of terminal hairs in a 4 cm² area at the junction of the frontal and lateral hairlines was measured. In 10 women randomized to receive the supplement, terminal hairs increased from 271 at baseline to 571 after 90 days of treatment and 610 after 180 days of treatment. The mean number of terminal hairs in five women randomized to receive placebo was 256 at baseline, 245 after 90 days, and 242 after 180 days, Dr. Glynis Ablon reported in a poster at the annual meeting of the American Society for Dermatologic Surgery.

The mean number of vellus hairs in the treatment group was 46.5 at baseline and did not appreciably change over 180 days; the mean number of vellus hairs in the placebo group was 57 at baseline, 68 at 90 days, and 66 at 180 days, said Dr. Ablon, a Manhattan Beach, Calif.–based dermatologist.

Treated subjects were significantly more likely to report improvements in overall hair volume, scalp coverage, and hair body thickness after 90 days. Improved hair shine, skin moisture retention, and skin smoothness were reported after 180 days, she noted.

Study participants were women aged 21-75 years (mean age, 50 in the treatment group and 48 in the control group) with Fitzpatrick I-IV skin types. All were in generally good health but had perceived hair thinning. All study participants agreed to maintain their baseline diet, medications, and exercise level during the study period, and to maintain consistent hair care throughout the study period.

Treatment group subjects were instructed to take one tablet of the proprietary supplement (Viviscal) each morning and evening with water after a meal.

The study was supported by Lifes2good Inc., the maker of Viviscal. Dr. Ablon received a research grant from Lifes2good.

A marine protein–based oral food supplement was safe and associated with significant hair growth in women with self-perceived thinning hair, according to findings from a small randomized controlled, double-blind study.

The mean number of terminal hairs in a 4 cm² area at the junction of the frontal and lateral hairlines was measured. In 10 women randomized to receive the supplement, terminal hairs increased from 271 at baseline to 571 after 90 days of treatment and 610 after 180 days of treatment. The mean number of terminal hairs in five women randomized to receive placebo was 256 at baseline, 245 after 90 days, and 242 after 180 days, Dr. Glynis Ablon reported in a poster at the annual meeting of the American Society for Dermatologic Surgery.

The mean number of vellus hairs in the treatment group was 46.5 at baseline and did not appreciably change over 180 days; the mean number of vellus hairs in the placebo group was 57 at baseline, 68 at 90 days, and 66 at 180 days, said Dr. Ablon, a Manhattan Beach, Calif.–based dermatologist.

Treated subjects were significantly more likely to report improvements in overall hair volume, scalp coverage, and hair body thickness after 90 days. Improved hair shine, skin moisture retention, and skin smoothness were reported after 180 days, she noted.

Study participants were women aged 21-75 years (mean age, 50 in the treatment group and 48 in the control group) with Fitzpatrick I-IV skin types. All were in generally good health but had perceived hair thinning. All study participants agreed to maintain their baseline diet, medications, and exercise level during the study period, and to maintain consistent hair care throughout the study period.

Treatment group subjects were instructed to take one tablet of the proprietary supplement (Viviscal) each morning and evening with water after a meal.

The study was supported by Lifes2good Inc., the maker of Viviscal. Dr. Ablon received a research grant from Lifes2good.

A marine protein–based oral food supplement was safe and associated with significant hair growth in women with self-perceived thinning hair, according to findings from a small randomized controlled, double-blind study.

The mean number of terminal hairs in a 4 cm² area at the junction of the frontal and lateral hairlines was measured. In 10 women randomized to receive the supplement, terminal hairs increased from 271 at baseline to 571 after 90 days of treatment and 610 after 180 days of treatment. The mean number of terminal hairs in five women randomized to receive placebo was 256 at baseline, 245 after 90 days, and 242 after 180 days, Dr. Glynis Ablon reported in a poster at the annual meeting of the American Society for Dermatologic Surgery.

The mean number of vellus hairs in the treatment group was 46.5 at baseline and did not appreciably change over 180 days; the mean number of vellus hairs in the placebo group was 57 at baseline, 68 at 90 days, and 66 at 180 days, said Dr. Ablon, a Manhattan Beach, Calif.–based dermatologist.

Treated subjects were significantly more likely to report improvements in overall hair volume, scalp coverage, and hair body thickness after 90 days. Improved hair shine, skin moisture retention, and skin smoothness were reported after 180 days, she noted.

Study participants were women aged 21-75 years (mean age, 50 in the treatment group and 48 in the control group) with Fitzpatrick I-IV skin types. All were in generally good health but had perceived hair thinning. All study participants agreed to maintain their baseline diet, medications, and exercise level during the study period, and to maintain consistent hair care throughout the study period.

Treatment group subjects were instructed to take one tablet of the proprietary supplement (Viviscal) each morning and evening with water after a meal.

The study was supported by Lifes2good Inc., the maker of Viviscal. Dr. Ablon received a research grant from Lifes2good.

When it comes to androgenetic alopecia, female pattern hair loss, and alopecia areata, the role of molecular genetic testing remains limited, but that’s not to say it won’t play a major role in the future, noted Dr. Pedram Yazdan.

In fact, molecular genetic testing will likely play a prominent role with respect to prediction and diagnosis of hair loss, disease severity, and expected response to therapy, he noted.

Genetic factors appear to play a significant role in hair-loss pathogenesis, but the remarkable advances in genomic discovery and molecular diagnostic testing seen in other areas of medicine haven’t quite made their way to this indication (Sem. Cut. Med. Surg. 2012;31:259-67).

"The current gold standard in diagnosis of these alopecias is by clinical history, examination, and, when necessary, scalp biopsy for histopathologic evaluation," wrote Dr. Yazdan of the department of dermatology at Northwestern University, Chicago.

An important role for molecular diagnostics likely lies in the small number of cases in which the diagnosis cannot be ascertained by the existing modalities – cases in which the clinical and histopathologic features of the condition are ambiguous and thus make a definitive diagnosis difficult, Dr. Yazdan noted.

Another role may relate to predicting the course and severity of hair loss, which is currently difficult to accomplish as "there are no reliable and validated clinical or histologic features that can provide patients with prognostic information," he wrote.

"It is conceivable that once the underlying genetic risk profiles of these forms of hair loss are more fully established, this information can potentially be used to aid in more definitively elucidating pathogenesis of the hair loss," which in turn, would aid in the development of diagnostic testing, he noted.

Molecular diagnostic testing for alopecia would also allow for risk stratification in terms of development and severity, and, importantly, would advance the field of pharmacogenetics for alopecia. Currently, treatment options are limited in both number and effectiveness.

Dr. Yazdan described a future in which both therapeutic and targeted preventive therapies, coupled with testing to determine treatment response potential, will allow for personalized treatment of these common and complex conditions, which cause patients substantial anxiety.

He reported having no conflicts of interest.

When it comes to androgenetic alopecia, female pattern hair loss, and alopecia areata, the role of molecular genetic testing remains limited, but that’s not to say it won’t play a major role in the future, noted Dr. Pedram Yazdan.

In fact, molecular genetic testing will likely play a prominent role with respect to prediction and diagnosis of hair loss, disease severity, and expected response to therapy, he noted.

Genetic factors appear to play a significant role in hair-loss pathogenesis, but the remarkable advances in genomic discovery and molecular diagnostic testing seen in other areas of medicine haven’t quite made their way to this indication (Sem. Cut. Med. Surg. 2012;31:259-67).

"The current gold standard in diagnosis of these alopecias is by clinical history, examination, and, when necessary, scalp biopsy for histopathologic evaluation," wrote Dr. Yazdan of the department of dermatology at Northwestern University, Chicago.

An important role for molecular diagnostics likely lies in the small number of cases in which the diagnosis cannot be ascertained by the existing modalities – cases in which the clinical and histopathologic features of the condition are ambiguous and thus make a definitive diagnosis difficult, Dr. Yazdan noted.

Another role may relate to predicting the course and severity of hair loss, which is currently difficult to accomplish as "there are no reliable and validated clinical or histologic features that can provide patients with prognostic information," he wrote.

"It is conceivable that once the underlying genetic risk profiles of these forms of hair loss are more fully established, this information can potentially be used to aid in more definitively elucidating pathogenesis of the hair loss," which in turn, would aid in the development of diagnostic testing, he noted.

Molecular diagnostic testing for alopecia would also allow for risk stratification in terms of development and severity, and, importantly, would advance the field of pharmacogenetics for alopecia. Currently, treatment options are limited in both number and effectiveness.

Dr. Yazdan described a future in which both therapeutic and targeted preventive therapies, coupled with testing to determine treatment response potential, will allow for personalized treatment of these common and complex conditions, which cause patients substantial anxiety.

He reported having no conflicts of interest.

When it comes to androgenetic alopecia, female pattern hair loss, and alopecia areata, the role of molecular genetic testing remains limited, but that’s not to say it won’t play a major role in the future, noted Dr. Pedram Yazdan.

In fact, molecular genetic testing will likely play a prominent role with respect to prediction and diagnosis of hair loss, disease severity, and expected response to therapy, he noted.

Genetic factors appear to play a significant role in hair-loss pathogenesis, but the remarkable advances in genomic discovery and molecular diagnostic testing seen in other areas of medicine haven’t quite made their way to this indication (Sem. Cut. Med. Surg. 2012;31:259-67).

"The current gold standard in diagnosis of these alopecias is by clinical history, examination, and, when necessary, scalp biopsy for histopathologic evaluation," wrote Dr. Yazdan of the department of dermatology at Northwestern University, Chicago.

An important role for molecular diagnostics likely lies in the small number of cases in which the diagnosis cannot be ascertained by the existing modalities – cases in which the clinical and histopathologic features of the condition are ambiguous and thus make a definitive diagnosis difficult, Dr. Yazdan noted.

Another role may relate to predicting the course and severity of hair loss, which is currently difficult to accomplish as "there are no reliable and validated clinical or histologic features that can provide patients with prognostic information," he wrote.

"It is conceivable that once the underlying genetic risk profiles of these forms of hair loss are more fully established, this information can potentially be used to aid in more definitively elucidating pathogenesis of the hair loss," which in turn, would aid in the development of diagnostic testing, he noted.

Molecular diagnostic testing for alopecia would also allow for risk stratification in terms of development and severity, and, importantly, would advance the field of pharmacogenetics for alopecia. Currently, treatment options are limited in both number and effectiveness.

Dr. Yazdan described a future in which both therapeutic and targeted preventive therapies, coupled with testing to determine treatment response potential, will allow for personalized treatment of these common and complex conditions, which cause patients substantial anxiety.

He reported having no conflicts of interest.

PRAGUE – Off-label use of oral finasteride at 5 mg/day proved safe and effective for the treatment of female pattern hair loss in 43 premenopausal women in an 18-month study.

Treatment effectiveness was assessed in two ways: patient satisfaction scores and two blinded investigators’ evaluation of photographs. As a precondition for study participation, patients needed to have normal serum androgen levels, no clinical signs of hyperandrogenism, and no wish to become pregnant ever again. They also had to go on drospirenone/ethinyl estradiol for oral contraception.

At the 6-month mark, 25 patients (58%) characterized their improvement as "huge" and 14 (33%) as moderate; 4 reported no improvement. These results were stable across time, with the women reporting the same results at 12 and 18 months of follow-up.

The investigators’ blinded assessments of patient photos were less generous: They characterized 19 patients (44%) as very improved, 17 as somewhat improved, and 7 as unimproved.

Diminished libido was reported by 8 patients; 4 had transient nausea or headaches, and 4 reported transient metrorrhagia. One patient had elevated liver function test results and was dropped from the study, Dr. Rui Oliveira-Soares said at the annual congress of the European Academy of Dermatology and Venereology.

"None of us are very pleased with the results we’re having with other drugs," Dr. Oliveira-Soares said. "Sometimes they are unsuccessful or have unacceptable adverse effects. Sometimes there is progression of disease despite every drug we use."

It has been known for more than 15 years that finasteride at 1 mg/day is an effective treatment for male pattern hair loss. It is approved for that indication, as well as for benign prostatic hypertrophy at 5 mg/day.

However, investigators found 12 years ago that finasteride at 1 mg/day is ineffective for female pattern hair loss (J. Am. Acad. Dermatol. 2000;43:768-76). And there have been conflicting reports as to whether the therapy is effective in female androgenetic alopecia at 2.5 mg/day, noted Dr. Oliveira-Soares of Hospital Cuf Descobertas in Lisbon.

Having recently shown in an as-yet-unpublished study that finasteride at a dosage of 5 mg/day was beneficial in postmenopausal women with androgenetic alopecia, Dr. Oliveira-Soares said he sought to learn whether this regimen was safe and effective in premenopausal women affected by the disorder. He reported on 43 patients treated with finasteride at 5 mg/day for 18 months, with formal outcome assessments conducted every 6 months.

Future studies should focus on how to identify likely nonresponders. Also, an 18-month study is not sufficient to draw solid conclusions about the possible long-term risks of extended therapy. An increased risk of breast cancer is a theoretic concern, although there are no clinical data to suggest it is an issue, he said.

The problem in conducting larger, longer-term studies of finasteride at 5 mg/day for female pattern hair loss is that because the drug is available as a relatively inexpensive generic, there is no industry interest in funding such research, he added.

Topical 2% minoxidil is the standard treatment for female pattern hair loss. Among the other drugs used are flutamide and spironolactone, which can have hepatic toxicity, and cyproterone acetate, which can have cardiovascular side effects.

Dr. Oliveira-Soares’ study was supported by hospital research funds. He reported having no relevant financial conflicts.

PRAGUE – Off-label use of oral finasteride at 5 mg/day proved safe and effective for the treatment of female pattern hair loss in 43 premenopausal women in an 18-month study.

Treatment effectiveness was assessed in two ways: patient satisfaction scores and two blinded investigators’ evaluation of photographs. As a precondition for study participation, patients needed to have normal serum androgen levels, no clinical signs of hyperandrogenism, and no wish to become pregnant ever again. They also had to go on drospirenone/ethinyl estradiol for oral contraception.

At the 6-month mark, 25 patients (58%) characterized their improvement as "huge" and 14 (33%) as moderate; 4 reported no improvement. These results were stable across time, with the women reporting the same results at 12 and 18 months of follow-up.

The investigators’ blinded assessments of patient photos were less generous: They characterized 19 patients (44%) as very improved, 17 as somewhat improved, and 7 as unimproved.

Diminished libido was reported by 8 patients; 4 had transient nausea or headaches, and 4 reported transient metrorrhagia. One patient had elevated liver function test results and was dropped from the study, Dr. Rui Oliveira-Soares said at the annual congress of the European Academy of Dermatology and Venereology.

"None of us are very pleased with the results we’re having with other drugs," Dr. Oliveira-Soares said. "Sometimes they are unsuccessful or have unacceptable adverse effects. Sometimes there is progression of disease despite every drug we use."

It has been known for more than 15 years that finasteride at 1 mg/day is an effective treatment for male pattern hair loss. It is approved for that indication, as well as for benign prostatic hypertrophy at 5 mg/day.

However, investigators found 12 years ago that finasteride at 1 mg/day is ineffective for female pattern hair loss (J. Am. Acad. Dermatol. 2000;43:768-76). And there have been conflicting reports as to whether the therapy is effective in female androgenetic alopecia at 2.5 mg/day, noted Dr. Oliveira-Soares of Hospital Cuf Descobertas in Lisbon.

Having recently shown in an as-yet-unpublished study that finasteride at a dosage of 5 mg/day was beneficial in postmenopausal women with androgenetic alopecia, Dr. Oliveira-Soares said he sought to learn whether this regimen was safe and effective in premenopausal women affected by the disorder. He reported on 43 patients treated with finasteride at 5 mg/day for 18 months, with formal outcome assessments conducted every 6 months.

Future studies should focus on how to identify likely nonresponders. Also, an 18-month study is not sufficient to draw solid conclusions about the possible long-term risks of extended therapy. An increased risk of breast cancer is a theoretic concern, although there are no clinical data to suggest it is an issue, he said.

The problem in conducting larger, longer-term studies of finasteride at 5 mg/day for female pattern hair loss is that because the drug is available as a relatively inexpensive generic, there is no industry interest in funding such research, he added.

Topical 2% minoxidil is the standard treatment for female pattern hair loss. Among the other drugs used are flutamide and spironolactone, which can have hepatic toxicity, and cyproterone acetate, which can have cardiovascular side effects.

Dr. Oliveira-Soares’ study was supported by hospital research funds. He reported having no relevant financial conflicts.

PRAGUE – Off-label use of oral finasteride at 5 mg/day proved safe and effective for the treatment of female pattern hair loss in 43 premenopausal women in an 18-month study.

Treatment effectiveness was assessed in two ways: patient satisfaction scores and two blinded investigators’ evaluation of photographs. As a precondition for study participation, patients needed to have normal serum androgen levels, no clinical signs of hyperandrogenism, and no wish to become pregnant ever again. They also had to go on drospirenone/ethinyl estradiol for oral contraception.

At the 6-month mark, 25 patients (58%) characterized their improvement as "huge" and 14 (33%) as moderate; 4 reported no improvement. These results were stable across time, with the women reporting the same results at 12 and 18 months of follow-up.

The investigators’ blinded assessments of patient photos were less generous: They characterized 19 patients (44%) as very improved, 17 as somewhat improved, and 7 as unimproved.

Diminished libido was reported by 8 patients; 4 had transient nausea or headaches, and 4 reported transient metrorrhagia. One patient had elevated liver function test results and was dropped from the study, Dr. Rui Oliveira-Soares said at the annual congress of the European Academy of Dermatology and Venereology.

"None of us are very pleased with the results we’re having with other drugs," Dr. Oliveira-Soares said. "Sometimes they are unsuccessful or have unacceptable adverse effects. Sometimes there is progression of disease despite every drug we use."

It has been known for more than 15 years that finasteride at 1 mg/day is an effective treatment for male pattern hair loss. It is approved for that indication, as well as for benign prostatic hypertrophy at 5 mg/day.

However, investigators found 12 years ago that finasteride at 1 mg/day is ineffective for female pattern hair loss (J. Am. Acad. Dermatol. 2000;43:768-76). And there have been conflicting reports as to whether the therapy is effective in female androgenetic alopecia at 2.5 mg/day, noted Dr. Oliveira-Soares of Hospital Cuf Descobertas in Lisbon.

Having recently shown in an as-yet-unpublished study that finasteride at a dosage of 5 mg/day was beneficial in postmenopausal women with androgenetic alopecia, Dr. Oliveira-Soares said he sought to learn whether this regimen was safe and effective in premenopausal women affected by the disorder. He reported on 43 patients treated with finasteride at 5 mg/day for 18 months, with formal outcome assessments conducted every 6 months.

Future studies should focus on how to identify likely nonresponders. Also, an 18-month study is not sufficient to draw solid conclusions about the possible long-term risks of extended therapy. An increased risk of breast cancer is a theoretic concern, although there are no clinical data to suggest it is an issue, he said.

The problem in conducting larger, longer-term studies of finasteride at 5 mg/day for female pattern hair loss is that because the drug is available as a relatively inexpensive generic, there is no industry interest in funding such research, he added.

Topical 2% minoxidil is the standard treatment for female pattern hair loss. Among the other drugs used are flutamide and spironolactone, which can have hepatic toxicity, and cyproterone acetate, which can have cardiovascular side effects.

Dr. Oliveira-Soares’ study was supported by hospital research funds. He reported having no relevant financial conflicts.