Department of Ultrasound, Affiliated Wuxi Fifth Hospital of Jiangnan University (The Fifth People's Hospital of Wuxi), Wuxi, Jiangsu, China.
Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Skin Res Technol. 2024 Jun;30(6):e13803. doi: 10.1111/srt.13803.
This study aimed to assess the efficacy of type A botulinum toxin treatment for androgenetic alopecia (AGA) using a combination of ultrasound and trichoscopy.
Ninety patients with AGA who visited the Department of Dermatology at the Second Affiliated Hospital of Soochow University from September 2021 to December 2022 were prospectively selected. These patients met the diagnostic criteria outlined in the Chinese Guidelines for the Diagnosis and Treatment of Androgenetic Alopecia. The alopecia severity in the male patients ranged between grades 2 and 4 on the Norwood-Hamilton Scale. The patients were randomly assigned to receive injections of the same type of biological agent in a double-blind manner, with injection sites being the vertex or bilateral temporal-frontal hairline. In this study, the botulinum toxin group comprised 72 patients who received a biological agent with 100 units of type A botulinum toxin. The control group included 18 patients, and the biological agent administered to them contained 0 units of type A botulinum toxin. The patients were observed using 22-MHz ultrasound and trichoscopy before treatment, and 1 month and 3 months after treatment to compare the differences in various parameters at the injection sites. The ultrasound parameters included average follicle width, length, and count. The trichoscopy parameters were the number of hairs within a 1-cm area on the counting scale. No artificial interventions were performed at the injection sites, and all examination conditions were consistent.
The patients in the botulinum toxin group had wider and longer average follicle width and length at the vertex 1 month and 3 months after treatment (p < 0.05), and wider and longer average follicle width and length in the left frontal area 3 months after treatment (p < 0.05) compared with those in the control group. The average follicle width and length gradually increased after treatment in the botulinum toxin group (p < 0.05), but no statistically significant differences were found in the control group (p > 0.05). The patients in the botulinum toxin group exhibited greater average follicle lengths after treatment at the vertex compared with the left frontal area (p < 0.05). No statistically significant differences were found in follicle count (p > 0.05) or hair count (p > 0.05) between the botulinum toxin and control groups after injection treatment.
The follicle width and length are effective parameters for evaluating the efficacy of type A botulinum toxin treatment for AGA. Ultrasound revealed that the changes in follicles at the vertex occurred earlier than those in the left frontal area following treatment. Additionally, the changes in follicles were detected earlier than the changes in hair count using ultrasound. Ultrasound combined with trichoscopy provided more parameters for evaluating the efficacy of type A botulinum toxin treatment for AGA, resulting in a more comprehensive evaluation.
本研究旨在评估使用超声和毛发镜联合A型肉毒毒素治疗雄激素性脱发（AGA）的疗效。
2021 年 9 月至 2022 年 12 月，苏州大学第二附属医院皮肤科前瞻性选择 90 例 AGA 患者。这些患者符合《中国人雄激素性脱发诊疗指南》中的诊断标准。男性患者的脱发严重程度在 Norwood-Hamilton 量表上为 2 至 4 级。患者以双盲方式随机接受相同类型的生物制剂注射，注射部位为头顶或双侧颞额发际线。在本研究中，肉毒毒素组 72 例患者接受 100 单位 A 型肉毒毒素的生物制剂。对照组包括 18 例患者，给予他们的生物制剂中不含 A 型肉毒毒素。治疗前、治疗后 1 个月和 3 个月，患者使用 22-MHz 超声和毛发镜观察注射部位的各项参数差异。超声参数包括平均毛囊宽度、长度和计数。毛发镜参数为计数标尺上 1cm 面积内的毛发数量。在注射部位不进行任何人工干预，所有检查条件保持一致。
治疗后 1 个月和 3 个月，肉毒毒素组患者头顶的平均毛囊宽度和长度较对照组增宽、变长（p<0.05），治疗后 3 个月左侧额区的平均毛囊宽度和长度也较对照组增宽、变长（p<0.05）。肉毒毒素组治疗后平均毛囊宽度和长度逐渐增加（p<0.05），但对照组无统计学差异（p>0.05）。治疗后，肉毒毒素组患者头顶的平均毛囊长度大于左侧额区（p<0.05）。注射治疗后，肉毒毒素组和对照组的毛囊计数（p>0.05）和毛发计数（p>0.05）无统计学差异。
毛囊宽度和长度是评估 A 型肉毒毒素治疗 AGA 疗效的有效参数。超声显示，治疗后头顶的毛囊变化早于左侧额区。此外，超声检测到的毛囊变化早于毛发计数。超声联合毛发镜为评估 A 型肉毒毒素治疗 AGA 的疗效提供了更多参数，从而进行更全面的评估。
