​Concommittant Therapies: Protein effective for Female Pattern Hair loss

141 Results of Concommittant Therapies for Female Pattern Hair Loss: Global Photography and Hair Mass Index Results in over 50 Patients 

With many thanks to the author:

Bernard P. Nusbaum, MD Miami Hair Institute, Coral Gables, FL, USA. Dr. Bernard Nusbaum has been performing hair transplant surgery since 1983. He is Past President of The American Board of Hair Restoration Surgery, and has served on the Board of Governors of The International Society of Hair Restoration Surgery. He is an Editor Emeritus of The Hair Transplant Forum and a Diplomate of the American Board of Dermatology. Dr. Nusbaum is a Voluntary Faculty Member of The Department of Dermatology and Cutaneous Surgery at the University Of Miami Miller School Of Medicine and regularly publishes medical articles on hair loss and hair restoration.

For full abstract please contact us.

141 Results of Concommittant Therapies for Female Pattern Hair Loss: Global Photography and Hair Mass Index Results in over 50 Patients Bernard P. Nusbaum, MD Miami Hair Institute, Coral Gables, FL, USA. Dr. Bernard Nusbaum has been performing hair transplant surgery since 1983. He is Past President of The American Board of Hair Restoration Surgery, and has served on the Board of Governors of The International Society of Hair Restoration Surgery. He is an Editor Emeritus of The Hair Transplant Forum and a Diplomate of the American Board of Dermatology. Dr. Nusbaum is a Voluntary Faculty Member of The Department of Dermatology and Cutaneous Surgery at the University Of Miami Miller School Of Medicine and regularly publishes medical articles on hair loss and hair restoration. B.P. Nusbaum: None. TAKE HOME MESSAGE: "Triple Therapy" consisting of topical application of minoxidil/ steroid solutions combined with low level laser therapy and a vitamin-amino acid oral supplement was extremely effective in a large number of patients with female pattern hair loss. Efficacy was demonstrated by coupling global photography and hair bundle mass measurements which showed high correlation. This treatment program was associated with a high level of compliance and infrequent, minor side effects. ABSTRACT: While minoxidil monotherapy has the largest amount of evidence- based proof of efficacy for female pattern hair loss (FPHL) there is increasing evidence that targeting the inflammatory component found in this disorder may have therapeutic value. In this regard, topical formulations of minoxidil with corticosteroids have been shown to be effective in treating these patients (1). Additionally, adding tretinoin to minoxidil may increase its efficacy (presumably by enhancing absorption) and once daily application of 5% minoxidil with 0.01% tretinoin has been shown to be equal in efficacy to twice daily 5% minoxidil alone (2). Once daily applications increase compliance, especially in female patients, who generally find topical products “messy” and prefer a bedtime dose. In recent years, there has been increasing interest in low-level therapy (LLLT) with several home use devices making their debut in the market place. A recent randomized, sham controlled, double blind, multicenter trial showed a statistically significant increase in terminal hair counts at 26 weeks in a study group of 122 women with FPHL(3). It has been postulated that concomitant hair loss treatments may act synergistically and the author has developed a combination therapy approach for FPHL with high levels of compliance and efficacy. The regimen consist of 1)topically applied minoxidil compounded with corticosteroids, with or without tretinoin,2) LLLT and,3)an oral supplement containing B vitamins, folate, zinc, biotin and L-cystine. We term the combination “Triple Therapy” To date, 45 patients with FPHL have been followed with global photography (Fotofinder) and hair bundle mass measurements (HBMM) (Hair Check). 37 patients using “triple therapy” showed a mean improvement in HBMM from baseline of 22% and 28% at 7and 14 months, respectively. In comparison, 8 pts who utilized the topical solution and oral supplement without LLLT showed a mean improvement in HBMM of 21% at 9 months and a decline to 19% at 14 months. Global photographic assessments correlated with HBMM in 80% of cases, consistent with previous reports by the author. Adverse effects have been infrequent and attributed to the topical solutions with 7% of patients developing irritant contact dermatitis to tretinoin, 2% facial hypertrichosis, and 2% with scalp folliculitis. These resolved with discontinuation of tretinoin, decreasing minoxidil concentration, and lowering topical steroid potency, respectively. 287 We are continuing to enlist new patients and expect to have 100 patients and statistical analysis by the time of presentation. To date we are aware of only one, recent publication which assessed 19 FPHL patients with global photography only, 18% of whom were on combination therapy and one on LLLT alone (4). We additionally expect the develop control groups for our study, despite the difficulties in doing so within a private practice setting. References 1)Magro Cm,et al. The role of inflammation and immunity in the pathogenesis of androgenetic alopecia. Journal of drugs in dermatology: JDD. Dec 2011; 10(12): 1404-1411. (2) Shin HS, et al.Efficacy of 5% minoxidil versus combined 5% minoxidil and 0.001% tretinoin for male pattern hair loss: a ramdomized, double-blind, comparative clinical trial. American journal of clinical dermatology. 2007;8(5):285-300 (3 Joaquin J. Jiminez,et al. Efficacy and safety of a Low-level Laser device in the treatment of Male and Female Pattern Hair loss: A Multicenter, Randomized, Sham Device-controlled, Double-blind Study.Am J Clin Dermtol (2014)15:115-127 (4) Andreia Munk, et al.Use of Low-Level Laser Therapy as Monotherapy or Concomitant Therapy for Male and Female Androgenetic Alopecia.Int J Trichology/2014/vol6/issue