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Med Hypotheses 2002 Nov;59(5):522-6
The hydraulic influence in androgen-related hair growth: implications in autoimmune disease.
Androgen-related changes in hair growth represent something of a mystery. Through the action of dihydrotestosterone (DHT), hair growth is increased in specific areas of the body. Elevated levels of DHT produce a general increase over the larger part of the body, often accompanied by hair loss in specific areas of the scalp. Because of this 'opposite' effect, a genetic difference in the hair follicles is proposed. This view is supported through the success of the 'plug graft' transplantation technique. However, this is unsatisfactory, because transplantation procedures that should work well according to this theory, ultimately fail. There is an alternative 'mechanism', that demonstrates its origins in the prime function of hair as an insulator. This simple mechanism makes sense of all the recognized effects of DHT in the dermal system, and throughout the body. In DHT-related hair growth it can be directly observed. The implication is that DHT achieves its effects through a primary physiological action that can be easily tested given the necessary expertise. Given existing knowledge, such a proven action of DHT would have serious implications for further understanding of female susceptibility to autoimmune disease.
Clin Exp Dermatol 2002 Jul;27(5):366-72
Clinical relevance of hair microscopy in alopecia.
Hair microscopy can clarify the cause of hair loss in a range of diagnoses. Most of these are associated with hair breakage, the rest are related to lack of growth. Hair breakage may be due to excessive trauma or underlying susceptibility, where structural clues may be present. Lack of growth reflects follicular dynamics and represents the central mechanism of most common causes of alopecia. In such conditions, microscopy only reveals nonspecific confirmation of short anagen. Although this may assist clinical diagnosis, microscopy in alopecia only allows exclusion of diagnoses related to hair breakage. Confidence in the outcome of hair microscopy is based on the size of the sample of hairs, the length of the hair, the characteristics of the observations and the experience of the person undertaking the microscopy.
J Theor Biol 2002 Feb 7;214(3):469-79
The follicular automaton model: effect of stochasticity and of synchronization of hair cycles.
Human scalp hair consists of a set of about 10(5)follicles which progress independently through developmental cycles. Each hair follicle successively goes through the anagen (A), catagen (C), telogen (T) and latency (L) phases that correspond, respectively, to growth, arrest and hair shedding before a new anagen phase is initiated. Long-term experimental observations in a group of ten male, alopecic and non-alopecic volunteers allowed determination of the characteristics of hair follicle cycles. On the basis of these observations, we previously proposed a follicular automaton model to simulate the dynamics of human hair cycles and the development of different patterns of alopecia [Halloy et al. (2000) Proc. Natl Acad. Sci. U.S.A.97, 8328-8333]. The automaton model is defined by a set of rules that govern the stochastic transitions of each follicle between the successive states A, T, L and the subsequent return to A. These transitions occur independently for each follicle, after time intervals given stochastically by a distribution characterized by a mean and a standard deviation. The follicular automaton model was shown to account both for the dynamical transitions observed in a single follicle, and for the behaviour of an ensemble of independently cycling follicles. Here, we extend these results and investigate additional properties of the model. We present a deterministic version of the follicular automaton. We show that numerical simulations of the stochastic version of the automaton yield steady-state level of follicles in the different phases which approach the levels predicted by the deterministic equations as the number of follicles progressively increases. Only the stochastic version can successfully reproduce the fluctuations of the fractions of follicles in each of the three phases, observed in small follicle populations. When the standard deviation is reduced or when the follicles become otherwise synchronized, e.g. by a periodic external signal inducing the transition of anagen follicles into telogen phase, large-amplitude oscillations occur in the fractions of follicles in the three phases. These oscillations are not observed in humans but are reminiscent of the phenomenon of moulting observed in a number of mammalian species.
Eur J Dermatol 2002 Jan-Feb;12(1):32-7
Finasteride improves male pattern hair loss in a randomized study in identical twins.
OBJECTIVES: This study compared the efficacy of finasteride with placebo in the treatment of male pattern hair loss (androgenetic alopecia) in nine pairs of male identical twins. METHODS: In this randomized, double-blind, placebo-controlled, single-center study, one twin from each identical twin pair received finasteride 1 mg/day for one year while the other received placebo. Hair growth was evaluated from standardized clinical photographs, hair counts and patient self-assessment questionnaires. Serum dihydrotestosterone and testosterone levels were analyzed and adverse events recorded. RESULTS: Finasteride significantly improved hair growth at one year compared to placebo (p < 0.05) based on analysis of photographs of the vertex and superior-frontal scalp. These results were consistent with the hair count change measured in the finasteride group, which was superior (p < 0.05) to the change measured in the placebo group. Patient self-assessment demonstrated that treatment with finasteride, in comparison to placebo, led to improvements in scalp hair growth and patients' satisfaction with appearance of hair. No drug-related adverse events were reported during the study. CONCLUSION: Through the use of identical twins, this study provides further evidence that finasteride significantly reduces hair loss progression and restores hair growth in men with male pattern hair loss.
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