Alopecia-Drampa Christina

 Alopecia is the general medical term for
hair loss
 Divided into:
 non scarring
 scarring

 androgenetic alopecia
 alopecia areata
 anagen effluvium
 telogen effluvium
 traumatic alopecia
 trichotillomania

 The high frequency of androgenetic alopecia
has complicated attempts to establish a mode
of inheritance
 Rapresents a complex polygenic trait
 The Androgen Receptor gene is located on the
X chromosome

 Dietary habits and alcohol abuse
 Stressful life events
 Sexual risk behavior and drug abuse
 Cigarette smoking
 UV exposure

•Date of onset of the hair loss problem
• Periodicity of hair loss
• Rate of progression
• Previous investigations and treatments
• Present and past health status
(Medications, incl. hormonal treatments)
• Dietary behavior
• Associated symptoms relating to the condition of the
scalp

 Iron deficiency
 Thyroid disorder
 Lupus erythematosus
 Intake of drugs or of hormones (oral
contraceptives, replacement therapies
that possess androgenic activity)

 Serum ferritin
 Fe + Ht
 Vitamin B12
 TSH +FT4
 Estradiol
 Progesterone
 DHT
 Testosterone
 Prolactin

1. Serum ferritin ( mg/L)
2. Vitamin B12 (ng/L)
3. Serum folic acid
(nmol/L)
4. Estradiol (day 21)
(pmol/L)
5. Progesterone (day 21)
(nmol/L)
1. >40
2. 300-1000
3. 5-40
4. >300
5. >30

Since high levels of serum ferritin are
engendered by inflammation
independently
of iron stores, it is important to
simultaneously
determine C-reactive protein (CRP)
levels

Clinical evidence for the role of estrogens
for hair growth is observations of the effects
of pregnancy, hormonal treatments that
affect estrogen metabolism, and menopause
on the condition of the hair

Dihydrotestosterone (DHT) is the specific
hormone responsible for male and female
pattern baldness as a result of changes in
its metabolism

 Male baldness: 5% minoxidil lotion, finasteride
taken orally and daily (1 mg) works by inhibiting
the 5α-reductase from forming DHT
 Female baldness: 2% minoxidil lotion,
cyproterone

 Amino acids (cysteine,
lysine, arginine)
 Iron supplements in
absence of deficiency
 Silic acid
 Marine extract and
silicea
 Trace elements (zinc,
copper)
 Vitamins (biotin)
 Ginkgo biloba
 Aloe vera
 Ginseng
 Bergamot
 Melatonin
 Retinoids

New interest in preventing hair-loss and baldness
has been stimulated by cellular therapy
infusing PRP into the scalp

The process consists of using autologous
platelet extracts as a cell-repairing product

Platelets:
150.000 –
400.000 mm³
Average
time llife:
5-9 days

Platelet Rich Plasma is blood plasma that has been
enriched with platelets
PRP contains and releases through degranulation
several different growth factors and other
cytokines that
stimulate healing of bone and soft tissue

Androgenetic alopecia involves a process
of premature termination of anagen associated
with premature entry into catagen

■ Platelet-derived growth factor (PDGF)
■ Vascular endothelial growth factor (VEGF)
■ Epidermal growth factor (EGF)
■ Insulin-like growth factor 1 (IGF-1)
■ Fibroblast growth factor (FGF)
■ Nerve growth factor (NGF)

Ratio volume
BLOOD:
9
COAGULATE:
SODIO
CITRATE
1

Different kind
of
measurements:
tubes are
centrifuged for
approximately
5-10 minutes at
600 G

1ml of lidocaine 1%
injected into the
following points:
1) 1,5 cm over the
supraorbital foramen,
deep in the
periosteum, in the
internal third of the
eyebrows
(supraorbital nerve)
2) 1,5 cm medially of
the first point
(supratrochlear nerve)
3) 1,5 cm in front of
the upper part of the
ear helix subdermally
(auriculo-temporal
nerve)

Light massage
is necessary to
spread the
anesthetic
Block starts in
60 sec
Maximum
action in 10
minutes
Time duration
is three hours
and more

10 patients with androgenetic alopecia:
 7 of them were male
 3 of them female
Were treated with PRP one session every
month for three months

Alopecia-Drampa Christina

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