Injectable botulinum toxin (BT) may have potential as a treatment for patients with androgenetic alopecia (AGA), researchers suggested in a commentary published in the Journal of Cosmetic Dermatology.
AGA is the most common form of alopecia, but the only FDA-approved treatments for the disorder are topical minoxidil in women and topical minoxidil and oral finasteride in men. However, recent research has suggested that injectable BT may be a possible adjuvant treatment for patients with the disorder.
Alteration of androgen sensitivity and genetic predisposition are important factors in the etiopathogenesis of the disease, and oxidative stress and perifollicular microinflammation are also contributing factors. In AGA, bald areas have lower oxygen levels than nonbald areas, the investigators recounted. Because conversion of testosterone to dihydrotestosterone (DHT) occurs in an environment with low oxygen levels, an increase in blood supply would reduce local hypoxia and could be beneficial in AGA, suggested the investigators.
DHT induces production of transforming growth factor-β1 (TGF-β1) in the cells of the dermal papilla. TGF-β1 has a relevant role in the onset of AGA, and antagonizing it could prevent disease progression, according to the researchers.
The rationale for using BT in patients with AGA would be to promote relaxation of the scalp muscles, which would reduce muscle pressure on perforating vessels and potentially increase blood and oxygen flow to bald areas, noted the investigators.
“Therefore, there would be a reduction in tissue DHT due to the effect known as ‘wash out,’ and consequently, less follicular miniaturization would occur, which is considered the main pathophysiological basis of this disease,” the researchers noted.
As men with AGA have been shown to have significantly greater stiffness at the apex of the scalp compared with other areas, this stiffness could be related to fibrosis promoted by increased levels of TGF-β1 in the sites affected by the disease. Thus, BT injection could inhibit TGF-β1 secretion from hair follicles, leading to an antifibrotic effect.
“As other complementary etiopathogenic mechanisms emerge, new hypotheses arise to complement already approved classic therapies,” the researchers commented. “In this sense, injectable BT seems to have a theoretical rationale that supports its use in order to expand the therapeutic arsenal for AGA, although robust clinical trials are needed to validate whether the rationale for its use is confirmed in clinical practice.”Read More
The first trend in aesthetic medicine is the appearance of mesotherapy preparations containing extracts from stem cells. Stem cells are the starting cells for the body, its tissues and organs. They are characterized by an outstanding ability to reproduce and produce a large number of daughter differentiated cells. They are often called stem cells, because it is from them that various cells in our body derive, as if from a common stem. Due to their origin, they are divided into embryonic and somatic stem cells found in the tissues of adult organisms. They are capable of producing cells from those tissues for which they are a parent.
Somatic stem cells are increasingly used in medicine. A large-scale procedure is transplantation of hematopoietic stem cells, often called bone marrow transplantation. The second treatment is to use the so-called mesenchymal stem cells to assist in the regeneration of damaged bones. Skin is an important source of somatic stem cells. They are mainly found in the basal layer of the epidermis and in the hair follicles. Thanks to their presence, the epidermis is constantly renewed. At the time of division, two cells are formed, one of which remains in the reproductive phase, and the other moves towards the upper layers of the epidermis, undergoing gradual keratinization. Stem cells live long, but their activity decreases with age.
Recently, a preparation for mesotherapy of the skin of the face and scalp has appeared in aesthetic medicine, containing extracts of somatic stem cells obtained from adipose tissue. Adipose-derived stem cells (ASC) are multipotent cells of which there are many in adipose tissue. Multipotent stem cells have the ability not only to repair or renew tissues immediately, but also to ensure their proper function in the regeneration process. The best known source of stem cells is bone marrow, but the number of cells obtained in this way is relatively small. Recently, adipose tissue has become an alternative source of stem cells. Liposuction is one of the most frequently performed procedures in aesthetic surgery and allows you to obtain a large number of stem cells.
Stem cell extracts administered to the skin by mesotherapy stimulate the stem cells present in the epidermis and hair follicles to differentiate into skin cells and stimulate the repair processes taking place in the dermis. So it is a revolutionary approach to the aging process and the latest trend in anti-aging medicine.Read More