Singh Sehdev, Neema Shekhar, Vasudevan Biju
Department of Dermatology, Command Hospital, Kolkata, West Bengal, India.
Department of Dermatology, Base Hospital, Kolkata, West Bengal, India.
J Cutan Aesthet Surg. 2017 Jul-Sep;10(3):163-167. doi: 10.4103/JCAS.JCAS_77_17.
Androgenetic alopecia is a common form of alopecia with multifactorial etiology. Finasteride and minoxidil are approved by the FDA for the treatment of androgenetic alopecia. Balding scalp is believed to have relative microvascular insufficiency. Blood vessels in the scalp travel through the intramuscular plane. Intramuscular injection of botulinum toxin relaxes muscles and thereby increases blood flow in balding scalp. We conducted a pilot study to evaluate the efficacy of botulinum toxin in androgenetic alopecia management.
The study was conducted in a tertiary care center. A total of 10 male patients with androgenetic alopecia meeting inclusion criteria of the study were included. In the scalp, 30 sites were injected with 5 U of botulinum toxin in each site. Preprocedure photograph taken and evaluation was done, which was repeated after 24 weeks. Efficacy was assessed by photography and self-assessment scoring was done by patients.
Of 10 patients, 8 had good to excellent response on photographic assessment. At the end of 24 weeks, 1 patient showed poor and 1 showed fair response to treatment. As per self-assessment, 7of 10 patients showed good to excellent response. Two patients had fair response and 1 patient showed poor response to treatment.
Botulinum toxin was found to be safe and effective therapy for the management of androgenetic alopecia in this pilot study. Studies with larger sample size and randomized controlled trials are required to establish the role of botulinum toxin in the management of androgenetic alopecia.
雄激素性脱发是一种常见的脱发形式,病因多因素。非那雄胺和米诺地尔已获美国食品药品监督管理局(FDA)批准用于治疗雄激素性脱发。人们认为秃发头皮存在相对的微血管功能不全。头皮中的血管穿行于肌内平面。肌内注射肉毒杆菌毒素可使肌肉松弛,从而增加秃发头皮的血流量。我们进行了一项初步研究,以评估肉毒杆菌毒素在雄激素性脱发治疗中的疗效。
该研究在一家三级医疗中心进行。共有10名符合该研究纳入标准的雄激素性脱发男性患者被纳入。在头皮上,30个部位每个部位注射5单位肉毒杆菌毒素。注射前拍照并进行评估,24周后重复进行。通过拍照评估疗效,患者进行自我评估评分。
10名患者中,8名在照片评估中显示出良好至极佳的反应。在24周结束时,1名患者显示反应较差,1名患者显示反应一般。根据自我评估,10名患者中有7名显示出良好至极佳的反应。2名患者反应一般,1名患者显示治疗反应较差。
在这项初步研究中,发现肉毒杆菌毒素是治疗雄激素性脱发的安全有效疗法。需要进行更大样本量的研究和随机对照试验来确定肉毒杆菌毒素在雄激素性脱发治疗中的作用。