This reference volume conveys complete understanding and management of Androgenetic Alopecia and Female Pattern Hair Loss (AGA/FPHL). These are probably the most common adult (18-50 yrs.) health disorders besides dental caries, accounting for over 98% of hair loss cases in males and over 70% cases in females. The present volume, the first of three related volumes, is structured in 4 sections: 22 dedicated chapters, ranging from basic science (Biology, Anatomy, Physiology, Embryology), the etiology of adult, childhood & adolescent AGA/FPHL, diagnostic steps and evaluation, to related disorders and comorbidities. For the first time in the scientific literature, all pathogenic contributors of AGA/FPHL, including micro-inflammation, scalp vascularization, biochemical stress, aging, solar radiation, and the sebaceous gland, are examined in comprehensive, dedicated chapters. The effects of every hormone on AGA/FPHL, as well as the psychological impact of the condition, are explored in depth. An extensive chapter on childhood and adolescent AGA/FPHL, a more common than previously thought condition, is another unique feature. Finally, two extremely detailed sections are included on the pathogenic links of AGA/FPHL to life-threatening comorbidities: cardiovascular disease, metabolic syndrome, hypertension, insulin resistance, and prostatic disorders, with suggested guidelines on how to save lives of balding patients by adopting early screening strategies.
In providing a fully updated, thorough guide to this popular topic, this richly illustrated volume (over 200 figures, tables, and algorithms) offers the latest, evidence-based information on every aspect of AGA/FPHL causing hair loss to countless patients. Each subject is addressed according to learning and clinical needs, and the presented information is supported by a wealth of peer-reviewed papers. Every aspect of this condition is considered, including biology, diagnosis, etiology, from drug treatment, the influence of nutrition, lifestyle and food supplements, to related disorders, surgical hair restoration, hair care, and future treatment options. This handbook will be an invaluable conveying best management standards to readers, whether experienced practitioners, clinicians, dermatologists, surgeons or researchers interested in hair restoration.
Author(s): Konstantinos Anastassakis
Publisher: Springer
Year: 2022
Language: English
Pages: 361
City: Cham
Foreword
Preface
Acknowledgments
Contents
Part I: The Hair Follicle Biology and Life
1: Hair Through the Ages
1.1 Why Is Hair So Important?
1.2 Influences
1.3 Socio-cultural Impact of Hair Loss
1.4 Hair in Prehistoric Antiquity
1.5 Hairdressing in Greek and Roman Antiquity
1.6 Middle Ages
1.7 Renaissance
1.8 The Century of the Wig
1.9 From the Nineteenth to the Twenty-first Century
1.10 Hair Today
1.11 Synopsis
References
2: The Mission of Hair Follicles and Hair
2.1 Functions of Hair Follicles
2.1.1 Sensation
2.1.2 Thermoregulation and Insulation
2.1.3 Protection from Solar Radiation
2.1.4 Physical Protection
2.1.5 Communication
2.2 Why Humans Lost Their Coat?
2.3 Is There An Evolutionary Explanation for AGA?
2.3.1 Theories on the Evolutionary Roles of AGA
2.3.2 What About FPHL?
2.4 What Is the “Role” of AGA Today?
2.5 Synopsis
References
3: Embryogenesis of Pilosebaceous Unit
3.1 History of Follicular Embryology
3.2 Hair Follicle Morphogenesis
3.3 Stages of the Embryological Development of Human Hair Follicles
3.4 Molecular Mediation of Follicular Embryogenesis
3.5 Synopsis
References
4: Morphology and Histology of the Pilosebaceous Unit
4.1 Hair Follicle Morphology
4.1.1 Bulb
4.1.1.1 Dermal Papilla
4.1.1.2 Inner Root Sheath
4.1.1.3 Outer Root Sheath
4.1.1.4 Vitreous Membrane
4.1.1.5 Connective Tissue Sheath
4.1.2 Suprabulbar Region
4.1.3 Isthmus
4.1.4 Infundibulum
4.2 Arrector Pili Muscle (APM)
4.3 Sebaceous Gland
4.4 Vascularization of the Hair Follicle
4.5 Synopsis
References
5: The Life Cycle of the Hair Follicle
5.1 A Cycle Unlike Any Other!
5.2 Why Do Mammals Have Fur Coats?
5.3 The Hair Follicle Life Cycle in Mammals and Humans
5.4 The Rhythm of Life of the Hair Follicle
5.5 Stages in the Cycling of Hair Follicles
5.5.1 The Anagen Stage
5.5.2 The Catagen Stage
5.5.3 The Telogen Stage
5.5.4 The Exogen Stage
5.5.5 The Kenogen Stage
5.6 Duration of Cycle Stages
5.7 Mosaic Hair Art!
5.8 Synopsis
References
6: The Morphology and Structure of the Hair Shaft
6.1 Basic Hair Anatomy
6.1.1 The Cuticle
6.1.2 The Cortex
6.1.3 The Medulla
6.2 The Chemical Composition of Hair
6.2.1 Protein
6.2.2 Water
6.2.3 Lipids
6.2.4 Melanin
6.2.5 Trace Elements
6.3 Chemical Bonds in Hair
6.3.1 Hydrogen Bonds
6.3.2 Salt Bonds
6.3.3 Cystine or Disulfide Bonds
6.3.4 Carbohydrate Bonds
6.4 Physical Properties of Hair
6.4.1 Hair Caliber
6.4.2 Tensile Strength and Torsion Forces
6.4.3 Compability
6.5 Synopsis
References
7: Types of Hair Follicles in Humans
7.1 Types of Hair Follicles
7.1.1 Lanugo Hair Follicle
7.1.2 Vellus Hair Follicle
7.1.3 Intermediate Hair Follicle
7.1.4 Terminal Hair Follicles
7.2 Transformation of Hair Follicles
7.3 Synopsis
References
8: The Effects of Aging on the Hair Follicle
8.1 Senile Alopecia vs. AGA: How Are they Different?
8.1.1 Is AGA Related to SA?
8.2 Hair Weathering
8.3 Graying
8.3.1 It’s Just an Illusion!
8.3.2 Premature Hair Graying
8.4 The Pathophysiology of Hair Graying
8.4.1 The Effects of Depigmentation on the Hair Fiber
8.4.2 Is Graying Reversible?
8.4.3 Canities and AGA
8.5 Synopsis
References
Part II: Diagnosis of Androgenetic Alopecia
9: Hair Growth Assessment Techniques in AGA/FPHL
9.1 Historical Overview
9.2 Methods for the Assessment of Hair Disorders
9.2.1 Hair Pull Test & Hair Feathering Test
9.2.2 Wash Test
9.2.3 Hair Weighing
9.2.4 Global Photography
9.2.5 Unit Area Trichogram
9.2.6 Phototrichogram (PTG)
9.2.7 Automated Phototrichogram: TrichoScan®
9.2.8 Dermoscopy and Trichoscopy
9.2.9 Digital Dermoscopy/Trichoscopy
9.2.10 Scalp Biopsy
9.3 Author’s Notes
9.4 Synopsis
References
10: Diagnostic Steps in the Evaluation of AGA/FPHL
10.1 Patient Medical History
10.2 Laboratory Tests
10.3 Gynecological History
10.4 Clinical Evaluation
10.4.1 Scalp Examination
10.4.2 Hair Examination
10.4.3 Trichoscopy
10.4.4 Clinical Picture
10.4.4.1 AGA
10.4.4.2 FPHL
10.4.4.3 Examination of Facial and Body Hair
10.5 Synopsis
References
Part III: Causes and Etiologic Parameters of AGA/FPHL
11: Hormonal and Genetic Etiology of Male Androgenetic Alopecia
11.1 Definition
11.2 Phenotype and staging of AGA
11.3 Natural Course of AGA
11.4 Epidemiology of AGA
11.5 Interracial Differences in AGA Epidemiology
11.6 Pathophysiology of AGA
11.6.1 Follicular Miniaturization
11.7 Inheritance of AGA
11.7.1 Some Background
11.7.2 Genetic Associations and AGA
11.7.3 Latest Findings in Genome Studies
11.8 Hormones and AGA
11.8.1 General Mechanism of Hormonal Action
11.8.2 Mechanism of Action of Androgens
11.8.3 How Did Androgens Correlate with AGA?
11.8.4 Androgens and Hair Follicles in Animals
11.8.5 Androgens and Hair Follicles in Humans: AGA and Observational Studies
11.8.6 Which Androgen Actually Causes Hair Loss?
11.8.7 Enzymic System of 5α-Reductase (5α-R)
11.9 Effects of Androgens in Hair Growth in General
11.10 Why Some Men Develop AGA, and Others Do Not?
11.10.1 Androgen Production
11.10.2 Androgen Transfer
11.10.3 Metabolism of Androgens in the Hair Follicles
11.10.4 Cellular Response to Androgen Action
11.10.4.1 Genomic Mode of Action
11.10.5 Nongenomic Mechanism of Action
11.11 How Exactly Do Androgens Act on the Hair Follicles?
11.12 Other Chemical Factors and AGA
11.13 Joining the Pieces
11.14 Recent Exciting Findings
11.14.1 MicroRNAs
11.14.2 Prolactin
11.14.3 BDNF (Brain-Derived Nerve Factor)
11.14.4 PCNAs
11.14.5 Wnt/β-catenin Signaling Pathway
11.14.6 IL-6
11.14.7 Prostaglandins, PTGDS
11.15 Synopsis
References
12: Female Pattern Hair Loss
12.1 Some History on Female AGA Aka FPHL
12.2 Histological and Phenotypic Features
12.3 FPHL and Androgens
12.4 Is FPHL Androgen-Independent?
12.4.1 Laboratory Tests
12.5 Genetics and FPHL
12.6 FPHL Presentation and Classification
12.6.1 Hamilton Scale
12.6.2 Ludwig Scale
12.6.3 Olsen Scale
12.6.4 Savin Scale
12.6.5 Sinclair Scale
12.7 Some Unique Features in FPHL Phenotype
12.8 Age at the Onset of FPHL
12.9 Incidence and Prevalence of FPHL
12.10 The Natural Course of FPHL
12.11 FPHL and Menopause
12.12 Management of FPHL
12.13 Synopsis
References
13: AGA/FPHL in Children and Adolescents
13.1 Hair Loss in Children
13.2 AGA in Children
13.2.1 Pathophysiology
13.2.2 Prevalence
13.3 Clinical Presentation and Differential Diagnosis
13.3.1 History and Clinical Examination
13.3.2 Systemic Associations
13.3.3 Studies on Children
13.3.4 Treatment
13.4 AGA in Adolescents
13.4.1 Pathophysiology
13.4.2 Prevalence
13.4.3 Clinical Presentation and Differential Diagnosis
13.4.4 History and Clinical Examination
13.4.5 Systemic Associations
13.4.6 Treatment
13.4.6.1 Minoxidil
13.4.6.2 Finasteride
13.4.7 Other Anti-androgens
13.5 Synopsis
References
14: Hair Follicle Microinflammation in AGA/FPHL
14.1 Immune Privilege and the Hair Follicle
14.2 Microinflammation, Fibrosis, and AGA
14.2.1 Microinflammation and Microbial Involvement
14.2.2 Microinflammation, Cytokines, and Inflammatory Cells
14.3 Hair Follicle Microinflammation and Androgens
14.4 Inflammasomes, Caspase-1 και AGA
14.5 Inflammation and Cicatricial Alopecia
14.6 Synopsis
References
15: The Role of the Sebaceous Gland in AGA/FPHL
15.1 About the Sebaceous Gland
15.2 The Endocrinology of the Sebaceous Gland
15.2.1 Sebaceous Gland, Enzymes, and Hormones
15.2.2 Sebaceous Gland and Androgen Production
15.2.3 The Sebaceous Gland, Androgens, and AGA
15.2.4 The Sebaceous Gland, Microbial Flora and Hair Loss
15.3 Is There a Conclusion?
15.4 Synopsis
References
16: The Role of Scalp Vascularization in AGA/FPHL
16.1 Theories of the Past
16.2 A Bit of Anatomy
16.3 Vascular Changes in AGA
16.3.1 Pathophysiologic Mechanisms
16.3.2 Scalp Changes in AGA
16.3.3 DHT and Vessels
16.4 Synopsis
References
17: The Role of Biochemical Stress in AGA/FPHL
17.1 Stress and the Skin
17.2 Is Stress Linked to Hair Loss?
17.2.1 Experimental Models and Stress
17.2.2 Stress as a Cause of Hair Loss in Animals
17.2.3 Stress as a Cause of Hair Loss in Humans
17.2.4 Stress and AGA. Is there a Link?
17.2.5 Stress Caused by Hair Loss Per Se
17.2.6 Putting the Pieces Together
17.3 Synopsis
References
18: The Role of Solar Radiation in AGA/FPHL
18.1 UVR and the Hair Follicle
18.2 UVR and AGA/FPHL
18.3 UVR-Induced Microinflammation
18.4 UVR-Induced Hair Damage
18.5 Photoprotection of the Scalp
18.6 Synopsis
References
19: Other Hormones Related to AGA/FPHL
19.1 Thyroid Hormones
19.2 Actions of Thyroid Hormones on the Hair Follicle
19.2.1 Systemic Effects
19.2.2 Local Administration of Thyroid Hormones
19.2.3 Studies in Human Hair Follicles
19.2.4 Clinical Studies
19.3 Parathyroid Hormone and Parathyroid Hormone-Related Protein
19.4 Vitamin D
19.5 Synopsis
References
20: The Psychological Effects of AGA/FPHL
20.1 Understanding and Empathy
20.2 Is It Just Vanity?
20.3 Physical Attractiveness Phenomena
20.4 AGA and Stereotypes
20.5 How Do Others View Balding Men?
20.6 How Do Men with AGA Feel About Themselves?
20.7 Do All Men with AGA Feel the Same?
20.7.1 Coping Mechanisms
20.8 The Psychological Effect of FPHL on Women
20.9 Patient Self-Evaluation of Hair Loss
20.10 How the Treatment of AGA Affects Patient Psychology
20.11 Should We Treat More Than Hair Loss?
20.12 Synopsis
References
Part IV: AGA/FPHL and Comorbidities
21: Cardiovascular Disease, Insulin Resistance, Metabolic Syndrome, and AGA/FPHL
21.1 Cardiovascular Disease and AGA
21.2 Is AGA (or a Specific Pattern of AGA) a Sign of CVD?
21.3 Studies on the Correlation Between CVD and AGA
21.4 Studies on the Link Between CVD and FPHL
21.5 Metabolic Syndrome and AGA
21.6 Studies on the Link Between Insulin Resistance, Metabolic Syndrome, and AGA
21.7 Arterial Hypertension and AGA
21.8 Can There Be a Unified Theory?
21.9 Synopsis
References
22: Prostate Disorders and AGA
22.1 Prostate Cancer
22.1.1 Androgens and Prostate Cancer
22.1.2 Similarities Between PCa and AGA
22.1.3 Why Are We Interested in the Relationship Between AGA with PCa?
22.1.4 Studies on the Correlation of PCa with AGA
22.1.5 Genome-Wide Association Studies (GWAS), AGA and PCa
22.2 Benign Prostatic Hyperplasia and AGA
22.3 AGA and Other Androgen-Related Disorders
22.4 Synopsis
References
Index
