The comparative histopathology of male-pattern baldness and senescent baldness

doi:10.1016/0738-081X(88)90074-0

Clinics in Dermatology

Volume 6, Issue 4, October–December 1988, Pages 108-118

https://doi.org/10.1016/0738-081X(88)90074-0 Get rights and content

Abstract

Although knowledge of normal scalp anatomy, the hair follicle, and the dynamics of hair cycling is substantial,^1–3 the histopathology of male-pattern baldness (MPB), also called premature baldness or androgenetic alopecia, is uncertain. Textbook accounts are uninformative,^4,5 and controversies are plentiful. Disputes exist about matters that seem quite simple, for example, whether the sebaceous glands are enlarged or shrunken. There are also opposing views on the fate of the arrector pili muscles. All agree that hair follicles become progressively smaller (miniaturized), but whether there is an actual loss of follicles is in contention. Two important publications on various cutaneous aspects of aging do not even include chapters on hair.^6,7

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The ending of estrogen production in the ovaries after menopause results in a series of important physiologic changes. In particular, it has been recognized as a factor impacting on hair texture and growth [4–13]. Indeed, clinical observations have revealed a clear effect of estrogen as an important modulator of hair growth and characteristics, supporting this hypothesis.
The ending of estrogen production in the ovaries after menopause results in a series of important physiologic changes, including hair texture and growth. In this study we demonstrate that Raman spectroscopy can be used successfully as a tool to probe menopause-induced changes on hair, in particular when coupled with suitable chemometrics approaches.
The detailed analysis of the average Raman spectra (in particular of the Amide I and νS-S stretching spectral regions) of the hair samples of women pre- and post-menopause allowed to estimate that absence of estrogen in post-menopause women leads to an average reduction of ∼12% in the thickness of the hair cuticle, compared to that of pre-menopause women, and revealed the strong prevalence of disulphide bonds in the most stable gauche–gauche–gauche conformation in the hair cuticle. From the analysis of the νS-S stretching spectral region it could also be concluded that the amount of α-helix keratin is slightly higher for post-menopause than for pre-menopause women.
A series of statistical models were developed in order to classify the hair samples. Outperforming the traditional PCA-LDA (principal component analysis – linear discriminant analysis) approach, in the present study a GA-LDA (genetic algorithm – linear discriminant analysis) strategy was used for variable reduction/selection and samples’ classification. This strategy allowed to develop of a statistical model (L16), which has exceptional prediction capability (total accuracy of 96.6%, with excellent sensitivity and selectivity) and can be used as an efficient instrument for the hair samples’ classification.
In addition, a new chemometrics approach is here presented, which allows to overcome the intrinsic limitations of the GA algorithm and that can be used to develop statistical models that use GA as the variable reduction/selection method, but superseding its stochastic nature. Three suitable models for classification of the hair samples according to the menopause status of the women were developed using this novel approach (LV17, BLV20 and PLS7 models), which are based on the Fisher’s and Bayers’ LDA approaches and the PLS-DA method. The followed new chemometrics approach uses the results of a large set of GA-LDA runs over the full data matrix for the selection of the reduced data matrices. The criterion for the selection of the variables is their statistical significance in terms of number of occurrences as solutions of the whole set of GA-LDA runs.
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Androgenic alopecia (AGA) is the commonest cause of hair loss in men with limited treatment options.
To compare the efficacy of PRP and minoxidil on experimentally induced AGA in adult male albino rats.
Thirty male albino rats were used. Group I (control group). Group II (AGA group): received testosterone only. Group III: received topical minoxidil. Group IV: received PRP /three days. Group V: received PRP and topical minoxidil.
Groups III, IV, and V showed significant increase in mean epidermal thickness, mean numbers of total hair follicles and anagen hair follicles, and decrease in telogen hair follicles compared to AGA group. Group V showed the best results. AGA group showed perifollicular fibrosis and follicular streamers. They were absent in PRP group and group V. Significant decrease of Ki-67 positive cells in AGA. PRP and minoxidil groups showed a significant increase in number of Ki-67 positive cells compared to control and AGA groups. Group V showed the highest number of Ki-67 positive cells.
PRP was more effective than minoxidil in treatment of experimentally induced AGA in rats. The best results were obtained when PRP and minoxidil were administered together.
Clinical Patterns of Hair Loss in Men: Is Dihydrotestosterone the Only Culprit?
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Senescent alopecia refers to diffuse scalp hair thinning seen with advanced age in individuals without a family history of hair loss or evidence of pattern balding. Senescent alopecia was described as a distinct process in the 1980s and is characterized histologically by a modest reduction in the size of otherwise normal hair follicles.79 This process was contrasted with the miniaturization, inflammation, and fibrosis seen with histologic evaluation of male pattern baldness.79
Age-Related Changes in Female Scalp Dermal Sheath and Dermal Fibroblasts: How the Hair Follicle Environment Impacts Hair Aging
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Citation Excerpt :
Search tool for retrieval of interacting genes analysis identified connections between proteins with specific clusters with established interactions (Figure 4b). With age, hair becomes thinner and brittle (Jeong et al., 2011; Kligman, 1988), with many women experiencing hair thinning (Monselise et al., 2017). Little is known about age-related changes in surrounding scalp skin and their impact on hair aging.
In women, aging leads to reduced hair density and thinner fibers and can result in female-pattern hair loss. However, the impact of the aging dermal environment on female scalp hair follicles remains unclear. In this study, we document in situ changes in 22 women (aged 19–81 years) and primary cultures of dermal fibroblast and dermal sheath cells. In situ, the papillary reticular boundary was indistinguishable in the young scalp but prominent in the scalp of those aged >40 years, accompanied by reduced podoplanin (PDPN) expression, increased versican expression, and changes in collagen organization. Hair follicles were shorter, not reaching the adipose layer. Hyaluronic acid synthase 2 was highly expressed, whereas matrix metalloproteinase 1 was elevated in the dermal papilla and dermal sheath in situ. Primary dermal fibroblast cultures confirmed that matrix metalloproteinase 1 mRNA, MMP1, increased with aging, whereas in dermal sheath cells, hyaluronic acid synthase 2, HAS2, and PDPN increased and α-smooth muscle actin αSMA mRNA decreased. Both exhibited increased cartilage oligomeric protein, COMP mRNA expression. Proteomics revealed an increase in dermal sheath proteins in the dermal fibroblast secretome with aging. In summary, aging female scalp shows striking structural and biological changes in the hair follicle environment that may impact hair growth.
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Hair follicle stem cells (HFSCs) and subsequent generations of matrix progeny make lineage choices by responding to spatiotemporal signals; however, the cues driving that specification are not well understood. Here, we demonstrate that the dynamics of microRNA (miR)-29 expression are inversely proportional to HFSC lineage progression. Furthermore, we show that sustained miR-29a/b1 overexpression in anagen or telogen in mice causes a short-hair phenotype and eventual hair loss by inhibiting the proliferation of HFSCs and matrix cells and likely preventing their differentiation. Conversely, in a loss-of-function in vivo model, miR-29a/b1 deficiency accelerates HFSC lineage progression in telogen. Mechanistically, miR-29a/b1 blocks HFSC lineage specification by spatiotemporally targeting Ctnnb1, Lrp6, Bmpr1a, and Ccna2. We further show that skin-specific Lrp6 or Bmpr1a ablation partially accounts for the short-hair phenotype. Overall, these synergistic targets reveal miR-29a/b1 as a high-fidelity antagonist of HFSC lineage progression and a potential therapeutic target for hair loss.
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Alopecia or hair loss is a worldwide unisex dermatological problem which affects aesthetic lifestyle qualities in humans. In recent years, drug discovery for hair loss has gained significant pharmaceutical research attention. Synthetic drugs such as minoxidil, oral finasteride, anthralin cream, and ketoconazole-based antifungal shampoos are some of the commercially available product formulations for hair loss treatment. As these products are mostly chemically derived, their long-term exposure to the skin could result in various side effects and skin disorders. As traditional medicine relies on herbs to treat alopecia, in recent times, different species of herbs are being extracted to generate functional bioactive chemicals as active ingredients to treat hair loss. These biologically derived phytochemicals may offer improved long-term biocompatibility with the skin. This chapter presents an overview of various phytochemicals with antialopecia properties and discusses their modes of action. Additionally, the efficiency of flavonoids, which is a major phytochemical constituent of several herbs and a potential 5α-reductase enzyme inhibitor, as a potential drug for alopecia treatment is also discussed.

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The comparative histopathology of male-pattern baldness and senescent baldness

Abstract

J Invest dermatol.

The Structure and Function of Skin

Aging of the human scalp

Disorders of epidermal appendages

Diseases of the Hair and Scalp

Aging in advances in biology of skin

J Invest dermatol.

Skin and Aging Processes

The pre-natal and post-natal hair cycles in man

Age changes in cutaneous appendages

J Appl Cosmetol

Common baldness in women

Transverse microscopic anatomy of the human scalp

Arch dermatol.

Anatomie der Haut: Handbuch der Haut und Geschlechtskrankheiten

The environment of the hair follicles