Smith Gregory L, Satino John
Medical Director, Medical Life Care Planners, St. Petersburg, FL, USA.
Laser Hair Center, Clearwater, FL, USA.
Cannabis. 2021 Apr 22;4(1):53-59. doi: 10.26828/cannabis/2021.01.003. eCollection 2021.
Androgenetic alopecia (AGA) is the most common cause of hair loss. Several FDA approved medications are available but offer limited results. Studies have shown that the endocannabinoid system (ECS) is a key player in hair follicle cell growth. The ECS cannabinoid type one (CB1) receptors are well expressed in the hair follicle cells. Cannabidiol CBD is a negative allosteric modulator of the CB1 receptor and has been shown to result in hair shaft elongation. In addition, the hair follicle cycle phases are controlled by the ECS vanilloid receptor-1 (TRPV1). CBD has also been shown to increase Wnt signaling pathways that are involved in the differentiation of dermal progenitor cells into new hair follicles and maintaining the anagen phase of the hair cycle. The effects of CBD on hair growth are dose dependent and higher doses may result in premature entry into the catagen phase via a receptor known as vanilloid receptor-4 (TRPV4). Topical application of CBD reaches hair follicles where it is a CB1 negative modulator, and TRPV1, and TRPV4 agonist. A study was done of 35 subjects with AGA using a once daily topical hemp oil formulation, averaging about 3-4 mg per day of CBD and minimal amounts of other cannabinoids for six months. A hair count of the greatest area of alopecia was carried out before treatment and again after six months. The results revealed that men did slightly better than women, and the vertex area did better than the temporal areas. On average there was statistically significant 93.5% increase in hair after 6 months. All subjects had some regrowth. There were no reported adverse effects. Since the CBD works through novel mechanisms different from finasteride and minoxidil it can be used in conjunction with these current drugs and would be expected to have synergistic effects.
雄激素性脱发(AGA)是脱发最常见的原因。有几种经美国食品药品监督管理局(FDA)批准的药物,但效果有限。研究表明,内源性大麻素系统(ECS)是毛囊细胞生长的关键因素。ECS的大麻素1型(CB1)受体在毛囊细胞中表达良好。大麻二酚(CBD)是CB1受体的负变构调节剂,已被证明可导致毛干伸长。此外,毛囊周期阶段由ECS的香草酸受体1(TRPV1)控制。CBD还被证明可增加Wnt信号通路,该通路参与真皮祖细胞分化为新毛囊以及维持毛发周期的生长期。CBD对毛发生长的影响具有剂量依赖性;较高剂量可能会通过一种名为香草酸受体4(TRPV4)的受体导致过早进入退行期。局部应用CBD可到达毛囊,在那里它是CB1负调节剂,以及TRPV1和TRPV4激动剂。对35名AGA患者进行了一项研究,使用每日一次的局部大麻油制剂,平均每天约3 - 4毫克CBD和极少量的其他大麻素,持续六个月。在治疗前和六个月后对脱发最严重的区域进行毛发计数。结果显示,男性的效果略好于女性,头顶区域的效果优于颞部区域。平均而言,六个月后毛发数量在统计学上有显著的93.5%的增加。所有受试者都有一定程度的毛发再生。没有报告不良反应。由于CBD通过与非那雄胺和米诺地尔不同的新机制起作用,它可以与这些现有药物联合使用,预计会有协同作用。