Übersichtsarbeit


Verbesserung der Behandlungsmethoden bei erblich bedingtem Haarausfall durch Standardisierung gemäß evidenzbasierter Medizin– Eine detaillierte Zusammenfassung

Keywords | Summary | Correspondence | Literature

Keywords

, , , ,

Schlüsselworte

, , , ,

Summary

Congenital hair loss, also known as androgenetic alopecia, has a significant impact on a person's self-confidence and quality of life and can even lead to depression. The miniaturization of hair follicles is the histological feature of AGA. This process does not progress synchronously and therefore differs from other forms of hair loss. Therapies only show effectiveness when intact hair follicles are still present! Therefore, an early diagnosis and initiation of AGA treatment are crucial for success. Although Minoxidil and Finasteride are mainly used for AGA treatment nowadays, current studies suggest that biological treatments with PRP, exosomes, and low-level laser therapy (e.g. Lasercaps) are effective alternatives with fewer side effects. Their effectiveness can be further improved through combination therapy. The issue of varying efficiency with the same therapeutic approach is not always due to the patient, but often to an improperly executed treatment concept by the physician. A prerequisite for successful AGA treatment is standardized procedures based on evidence-based medicine

Zusammenfassung

Der genetisch bedingte Haarausfall, auch bekannt als androgenetische Alopezie (AGA), hat einen signifikanten Einfluss auf das Selbstvertrauen und die Lebensqualität einer Person und kann sogar zu Depressionen führen. Die Verkleinerung der Haarfollikel ist das histologische Merkmal der AGA. Dieser Prozess verläuft nicht synchron und unterscheidet sich daher von anderen Formen des Haarausfalls. Therapien zeigen nur Wirkung, wenn intakte Haarfollikel noch vorhanden sind! Daher sind eine frühzeitige Diagnose und Einleitung der AGA-Behandlung entscheidend für den Erfolg. Obwohl Minoxidil und Finasterid heutzutage hauptsächlich zur Behandlung von AGA eingesetzt werden, deuten aktuelle Studien darauf hin, dass biologische Behandlungen mit PRP, Exosomen und Low-Level-Laser-Therapie (z.B. Lasercap) wirksame Alternativen mit geringeren Nebenwirkungen darstellen. Ihre Wirksamkeit kann durch eine Kombinationstherapie weiter verbessert werden. Das Problem der variierenden Effizienz bei demselben therapeutischen Ansatz liegt nicht immer beim Patienten, sondern häufig an einem nicht fachgerecht durchgeführten Behandlungskonzept des Arztes. Eine Voraussetzung für eine erfolgreiche Behandlung von AGA sind standardisierte Verfahren, die auf evidenzbasierter Medizin beruhen.

Leider haben Sie sich nicht eingeloggt, um den Beitrag lesen zu können. Bitte loggen Sie sich ein oder beantragen Sie Ihre Zugangsberechtigung. Vielen Dank. Weitere Informationen finden Sie hier>

Korrespondenz-Adresse

Dr. Bruce Reith, MD, PhD
Praxis Dr. Reith
Brunnstrasse 11
DE-80331 München
Bodenseeklinik Prof. Dr. Mang
Plastische, Ästhetische und Rekonstruktive Chirurgie
Graf-Lennart-Bernadotte-Str. 1
DE 88131 Lindau / Bodensee
www.brucereith.com
brucereith@me.com

Literatur

1. Stough D, Stenn K, Haber R, Parsley WM, Vogel JE, Whiting DA, Washenik K. Psychological effect, pathophysiology, and management of androgenetic alopecia in men. Mayo Clin Proc. 2005; 80 (10): 1316 -1322.
2. Severi G, Sinclair R, Hopper JL, et al. Androgenetic alopecia in men aged 40 – 69 years: prevalence and risk factors. Br J Dermatol. 2003; 149: 1207-13.
3. Grimalt R. Psychological aspects of hair disease. J Cosmet Dermatol. 2005; 4: 142-147.
4. Masic I, Miokovic M, Muhamedagic B. Evidence based medicine - new approaches and challenges. Acta Inform Med. 2008; 16 (4): 219 - 225.
5. Sackett DL, Richardson WS, Rosenberg W, Haynes RB. Evidence-based medicine: how to practice and teach. 2. ed. Edinburgh: Churchill-Livingstone, 2000.
6. Sinclair R, Torkamani N, Jones L. Androgenetic alopecia: new insights into the pathogenesis and mechanism of hair loss. F1000Res. 2015 Aug 19; 4 (F1000 Faculty Rev): 585.
7. Kanti V, Messenger A, Dobos G, et. Al. S3-Evidence- based (S3) guideline for the treatment of androgenetic alopecia in women and in men – short version, J Eur Acad Dermatol Venerol. 2018; 32 (1): 11 – 22.
8. Adil A, Godwin M. The effectiveness of treatments for androgenetic alopecia: A systematic review and meta-analysis. J Am Acad Dermatol. 2017; 77(1): 136-141.e5.
9. Zhou Y, Seo J, Tu S, Nanmo A, Kageyama T, Fukuda J. Exosomes for hair growth and regeneration. J Biosci Bioeng. 2024; 137(1): 1-8.
10. Pirmez R. The dermatoscope in the hair clinic: Trichoscopy of scarring and nonscarring alopecia. J Am Acad Dermatol. 2023; 89(2S): S9-S15.
11. Sinclair R, Jolley D, Mallari R, Magee J. The reliability of horizontally sectioned scalp biopsies in the diagnosis of chronic diffuse telogen hair loss in women. J Am Acad Dermatol. 2004; 51(2): 189-99.
12. Asfour L, et al., Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000–. PMID: 25905192.
13. Torkamani N, Rufaut NW, Jones L, et al. Destruction of the arrector pili muscle and fat infiltration in androgenic alopecia. Br J Dermatol. 2014; 170(6): 1291–8.
14. A, Rakowska A, Olszewska M, Rudnicka L. Trichoscopy of androgenetic alopecia: a systematic review. J Clin Med. 2024; 13(7): 1962.
15. Paichitrojjana A, Paichitrojjana A. Platelet rich plasma and its use in hair regrowth: a review. Drug Des Devel Ther. 2022; 16: 635-645.
16. Dovi et al. Accelerated wound closure in neutrophil-depleted mice. J Leukoc Biol. 2003; 73: 448-455.
17. Gentile P, Garcovich S, Bielli A, Scioli MG, Orlandi A, Cervelli V. The effect of plateletrich plasma in hair regrowth: A randomized placebo-controlled trial. Stem Cells Transl Med. 2015; 4: 1317–23.
18. Berndt S, Turzi A, Pittet-Cuénod B, Modarressi A. Autologous platelet-rich plasma (Cute Cell PRP) safely boosts in vitro human fibroblast expansion. Tissue Eng Part A. 2019;25 (21-22): 1550-1563.
19. DeLong JM, Russell RP, Mazzocca AD. Platelet-rich plasma: the PAW classificationmsystem. Arthroscopy. 2012;28 (7): 998-1009.
20. Tajima T, Yoshida E, Yamashita A, et. al. Hemoglobin stimulates the expression of matrix metalloproteinases, MMP-2 and MMP-9 by synovial cells: a possible cause of joint damage after intra-articular hemorrhage. J Orthop Res. 2005; 23: 891-898.
21. Bausset O, Magalon J, Giraudo L, Louis ML, Serratrice N, Frere C, Magalon G, Dignat-George F, Sabatier F. Impact of local anaesthetics and needle calibres used for painless PRP injections on platelet functionality. Muscles Ligaments Tendons J. 2014; 4(1): 18-23.
22. Gupta AK, Bamimore M. Platelet-rich plasma monotherapies for androgenetic alopecia: a network meta-analysis and meta-regression study. J Drugs Dermatol. 2022; 21(9): 943-952
23. Dhurat R, Sukesh M, Avhad G, Dandale A, Pal A, Pund P. A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: a pilot study. Int J Trichology. 2013; 5(1): 6-11.
24. Pei D, Zeng L, Huang X, Wang B, Liu L, Zhang G. Efficacy and safety of combined microneedling therapy for androgenic alopecia: A systematic review and meta-analysis of randomized clinical trials. J Cosmet Dermatol. 2024; 23(5): 1560-1572.
25. Sasaki GH. Micro-needling depth penetration, presence of pigment particles, and fluoresceinstained platelets: Clinical usage for aesthetic concerns. Aesthet Surg J. 2017; 37: 71–83.
26. Greco J, Brandt R. The effects of autologus platelet rich plasma and various growth factors on non-transplanted miniaturized hair. Hair Transplant Forum Int. 2009; 19(2): 49-50.
27. Effectiviness of autologous PRP combination with microneedling vs. microneedling alone for the treatment of AGA: a RCT split –scalp study, Ratchathorn Panchaprateep, MD, Bankgkok 2020.
28. Gentile P, Garcovich S. The effectiveness of low-level Llight/laser therapy on hair loss. Facial Plast Surg Aesthet Med. 2024; 26(2): 228-235.
29. Esmat SM, Hegazy RA, Gawdat HI, Abdel Hay RM, Allam RS, El Naggar R, Moneib H. Low level light-minoxidil 5% combination versus either therapeutic modality alone in management of female patterned hair loss: A randomized controlled study. Lasers Surg Med. 2017; 49(9): 835-843.
30. Liu KH, Liu D, Chen YT, Chin SY. Comparative effectiveness of low-level laser therapy for adult androgenic alopecia: a system review and meta-analysis of randomized controlled trials. Lasers Med Sci. 2019; 34(6): 1063-1069.
31. Eells JT, Wong-Riley MT, VerHoeve J, Henry M, et. al. Mitochondrial signal transduction in accelerated wound and retinal healing by near-infrared light therapy. Mitochondrion. 2004; 4(5-6): 559-67.
32. Hashmi JT, Huang YY, Sharma SK, Kurup DB, De Taboada L, Carroll JD, Hamblin MR. Effect of pulsing in low-level light therapy. Lasers Surg Med. 2010; 42(6): 450-66.
33. Gupta AK, Bamimore MA. Factors influencing the effect of photobiomodulation in the treatment of androgenetic alopecia: A systematic review and analyses of summary-level data. Dermatol Ther. 2020; 33(6): e14191.
34. Guo Y, Qu Q, Chen J, Miao Y, Hu Z. Proposed mechanisms of low-level light therapy in the treatment of androgenetic alopecia. Lasers Med Sci. 2021; 36(4): 703-713.
35. Munck A, Gavazzoni M, Trüeb R. Use of low-level laser therapy as monotherapy or concomitant therapy for male and female androgenetic alopecia. International Journal of Trichology. 6(2): 45-49.
36. Rajput RJ. Controversy: is there a role for adjuvants in the management of male pattern hair loss? J Cutan Aesthet Surg. 2010; 3(2): 82-6.
37. Guo H, Gao WV, Endo H, McElwee KJ. Experimental and early investigational drugs for androgenetic alopecia. Expert Opin Investig Drugs. 2017; 26 (8): v917 – 932.
38. Ajit A, Nair MD, & Venugopal B. Exploring the potential of mesenchymal stem cell–derived exosomes for the treatment of alopecia. Regenerative Engineering and Translational Medicine. 2021; 7: 119-128.
39. Kost Y, Muskat A, Mhaimeed N, Nazarian RS, & Kobets K. (2022). Exosome therapy in hair regeneration: A literature review of the evidence, challenges, and future opportunities. J Cosmet Dermatol. 2022; 21(8): 3226-3231.
40. Crabtree Judy et al. A Mouse Model of Androgenetic Alopecia, Endocrinology. 2010; 151 (5): 2373-238.

Ausgabe