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Australas J Dermatol 2002 Nov;43(4):311-2

Sensitization to saw palmetto and minoxidil in separate topical extemporaneous treatments for androgenetic alopecia.


We report a 24-year-old woman with androgenetic alopecia who became sensitized to topical minoxidil following use of an extemporaneous preparation of minoxidil 4% with retinoic acid in a propylene glycol base. She subsequently also became sensitized to saw palmetto (Serenoa repens), a topical herbal extract commonly promoted for the treatment of hair loss.


Dermatol Surg 2002 Sep;28(9):783-94

The art of repair in surgical hair restoration part I: basic repair strategies.


BACKGROUND: An increasingly important part of many hair restoration practices is the correction of hair transplants that were performed using older, outdated methods, or the correction of hair transplants that have left disfiguring results. The skill and judgment involved in these repair procedures often exceed those needed to operate on patients who have had no prior surgery. The use of small grafts alone does not protect the patient from poor work. Errors in surgical and aesthetic judgment, performing procedures on noncandidate patients, and the failure to communicate successfully with patients about realistic expectations remain major problems. OBJECTIVE: This two-part series presents new insights into repair strategies and expands upon several techniques previously described in the hair restoration literature. The focus is on creative aesthetic solutions to solve the supply/demand limitations inherent in most repairs. This article is written to serve as a guide for surgeons who perform repairs in their daily practices. METHODS: The repairs are performed by excision with reimplantation and/or by camouflage. Follicular unit transplantation is used for the restorative aspects of the procedure. RESULTS: Using punch or linear excision techniques allows the surgeon to relocate poorly planted grafts to areas that are more appropriate. In special situations, removal of grafts without reimplantation can be accomplished using lasers or electrolysis. The key elements of camouflage include creating a deep zone of follicular units, angling grafts in their natural direction, and using forward and side weighting of grafts to increase the appearance of fullness. The available donor supply is limited by hair density, scalp laxity, and scar placement. CONCLUSION: Presented with significant cosmetic problems and severely limited donor reserves, the surgeon performing restorative hair transplantation work faces distinct challenges. Meticulous surgical techniques and optimal utilization of a limited hair supply will enable the surgeon to achieve the best possible cosmetic results for patients requiring repairs.


Rev Environ Health 2001 Jul-Sep;16(4):233-51

Adverse health effects of selenium in humans.


Epidemiologic studies and case reports have shown that chronic exposure to selenium compounds is associated with several adverse health effects in humans. An early toxic effect of selenium is on endocrine function, particularly on the synthesis of thyroid hormones following dietary exposure of around 300 micrograms Se/d, and on the metabolism of growth hormone and insulin-like growth factor-1. Other adverse effects of selenium exposure can be the impairment of natural killer cells activity and at higher levels, hepatotoxicity and gastrointestinal disturbances. Dermatologic effects, such as nail and hair loss and dermatitis, occur after exposure to high levels of environmental selenium. Assessing the toxicity and morbidity after long-term exposure to environmental selenium is difficult: neurotoxicity, particularly the degeneration of motor neurons leading to increased risk of amyotrophic lateral sclerosis, might occur after chronic exposure to both organic and inorganic selenium compounds. The results of laboratory investigations and cohort studies suggest that selenium species exhibit a bivalent effect in cancer, either increasing or decreasing risk. Current environmental selenium exposure limits appear to be inadequate for averting adverse health effects.


J Liposome Res. 2002 Feb-May;12(1-2):143-8.

Follicular liposomal delivery systems.


Traditionally, the prime pathway for the topical delivery of active agents across the skin was thought to be through intercellular routes and transcellular routes of the stratum corneum. However, alternative means such as via appenageal transport, i.e., follicular transport, is gaining more acceptances in the scientific community. Targeting specific sites of the hair follicle may represent a feasible therapeutic approach to skin diseases such as hair loss. It is therefore an object of this research to develop novel liposomal formulations for enabling the topical delivery of difficult-to-absorb agents for localized action, specifically to the hair follicles and sebaceous glands. We examined small and large molecules. The small molecule chosen was minoxidil, a known hair growth stimulator. The large molecular weight molecule was plasmid DNA encoded with interleukin-1 receptor antagonist protein (IL-1ra).


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