SCIENCE SECTION 8 AMERICAN JOURNAL OF MESOTHERAPY INTRODUCTION Androgenic alopecia is a common disorder affecting both men and women. Both androgenic alopecia and telogen efflu- vium can be treated with mesotherapy, with results ranging from good to excellent. During the Fourth International Meso- therapy Congress in 1985, the first paper outlining a protocol on this topic was presented by Dr. Philippe Petit. Androgenic alopecia is defined by a chronic, diffuse, pro- gressive hair loss. Patients have hair loss in a ratio of 2 to 1, that is, for every 2 new hair threads, one is lost. Onset is gradual and appears to be determined by the pres- ence of circulating androgens and the degree of genetic pre- disposition. Men present with gradual thinning in the tempo- ral areas, producing a reshaping of the hair line. Women gen- erally present with diffuse thinning on the crown, generally maintaining a frontal hairline. But the evolution of baldness progresses in both men and women. INDICATION A clinical exam and a tricographic exam (or tricogram) are essential for the correct diagnosis and choosing therapy. Hair loss does not start until after puberty, and the rate of progres- sion is extremely variable, with some periods of remission. Some patients show evidence of the disorder by age 17 or 18 years, marked by significant scalp hair loss, which is stressful and may have associated psychosocial consequences. To diagnose androgenic alopecia, the physician should take the following steps: 1. Take a detailed patient history 2. Perform a clinical exam 3. Perform complementary exams 4. Make a positive diagnosis 5. Select mesotherapy treatment, based on patient history of: A. Patterns of family inheritance - B. Seborrhea - C. Itching and greasy pellicle - D. Patient’s anxiety level and dystonic characteristics E. Medication history Clinical Exam. The clinical exam should include an Alopecia Level evalua- tion, using the Hamilton classification for men and Ludwig classification for women. A traction exam will estimate the amount of hair loss. Complementary Exams A complete hormonal evaluation should be done in women to rule out hyperandrogenism (which can cause acne and hir- sutism), whereas normal levels of hormones are found in an- drogenic alopecia. It is also important to have the tricogram exam analyzed to evaluate the hair cycle dynamics. During successive passages through the hair cycle, the anagen phase becomes shorter and the telogen phase elongates, and the anagen to telogen ratio decreases. Positive Diagnosis Once a positive diagnosis of alopecia is established through the steps above, mesotherapy treatment is indicated. Medical Therapies Manual or electronic techniques can be used. Devices like the DenHub or Pistormatic are also suitable. The medications used are bepanthene, biotin, and a vasodilator such as peridil- heparin, and basic medicines; conjonctil and x-adene. Like all mesotherapy medicines, these must be diluted with procaine Patrícia Guedes Rittes, MD ALOPECIA
Transcript
SCIENCE SECTION
8 A M E R I C A N J O U R N A L O F M E S O T H E R A P Y
INTRODUCTIONAndrogenic alopecia is a common disorder affecting both
men and women. Both androgenic alopecia and telogen efflu-
vium can be treated with mesotherapy, with results ranging
from good to excellent. During the Fourth International Meso-
therapy Congress in 1985, the first paper outlining a protocol
on this topic was presented by Dr. Philippe Petit.
Androgenic alopecia is defined by a chronic, diffuse, pro-
gressive hair loss. Patients have hair loss in a ratio of 2 to 1,
that is, for every 2 new hair threads, one is lost.
Onset is gradual and appears to be determined by the pres-
ence of circulating androgens and the degree of genetic pre-
disposition. Men present with gradual thinning in the tempo-
ral areas, producing a reshaping of the hair line. Women gen-
erally present with diffuse thinning on the crown, generally
maintaining a frontal hairline. But the evolution of baldness
progresses in both men and women.
INDICATIONA clinical exam and a tricographic exam (or tricogram) are
essential for the correct diagnosis and choosing therapy. Hair
loss does not start until after puberty, and the rate of progres-
sion is extremely variable, with some periods of remission. Some
patients show evidence of the disorder by age 17 or 18 years,
marked by significant scalp hair loss, which is stressful andmay have associated psychosocial consequences.
To diagnose androgenic alopecia, the physician should take
the following steps:
1. Take a detailed patient history
2. Perform a clinical exam
3. Perform complementary exams
4. Make a positive diagnosis
5. Select mesotherapy treatment, based on patient history of:
A. Patterns of family inheritance
- B. Seborrhea
- C. Itching and greasy pellicle
- D. Patient’s anxiety level and dystonic characteristics
E. Medication history
Clinical Exam.The clinical exam should include an Alopecia Level evalua-
tion, using the Hamilton classification for men and Ludwig
classification for women. A traction exam will estimate theamount of hair loss.
Complementary ExamsA complete hormonal evaluation should be done in women
to rule out hyperandrogenism (which can cause acne and hir-
sutism), whereas normal levels of hormones are found in an-
drogenic alopecia.
It is also important to have the tricogram exam analyzed to
evaluate the hair cycle dynamics. During successive passages
through the hair cycle, the anagen phase becomes shorter and
the telogen phase elongates, and the anagen to telogen ratio
decreases.
Positive DiagnosisOnce a positive diagnosis of alopecia is established through
the steps above, mesotherapy treatment is indicated.
Medical TherapiesManual or electronic techniques can be used. Devices like
the DenHub or Pistormatic are also suitable. The medications
used are bepanthene, biotin, and a vasodilator such as peridil-
heparin, and basic medicines; conjonctil and x-adene. Like all
mesotherapy medicines, these must be diluted with procaine
Patrícia Guedes Rittes, MD
ALOPECIA
9S C I E N C E S E C T I O N
2%. Note that these medications should not be
combined in a single injection, but 2 drugs at a
time can be injected, using the following proto-
col for treating alopecia:
Sessions 1
through 5 are performed every 15 days:
Day 0 peridil-heparin + x-adene
Day 15 bepanthene + biotin
Day 30 minoxidil + conjonctil
Day 45 peridil-heparin + x-adeneDay 60 bepanthene + biotin
Subsequent
sessions are performed every 30 days:
Day 90 minoxidil + conjoctil
Day 120 peridil-heparin + x-adene
Day 150 bepanthene + biotin
Repeat this protocol.every 30 days
until day 360
Day 360 Perform another tricogram
In his experience, Dr. Pistor has never had any adverse incidents and has never used corticosteroids or progesterone.
TO ORDER PLEASE FAX: AUS: +61 2 9698 7952 OR USA+ 773 481 2516 TITLE: _________________FIRSTNAME: ________________________ SURNAME: _________________________ SPECIALTY: __________________________________________________________________________________
AMERICAN JOURNAL OF MESOTHERAPY ANNUAL SUBSCRIPTION REQUEST
Medicine is an ever-changing landscape. All areas of medicine transform with such speed that keeping up with the changes requires onstant access to medical information. Mesotherapy, a new and fascinating area of medicine, is in its infancy but has already gained unprecedented popularity and recognition in the medical community. A number of academies, associations, and societies have been formed to disseminate knowledge and provide basic mesotherapy training. Approximately 16,000 US physicians use mesotherapy in their daily medical practice, and the number of mesotherapy-trained physicians grows by 300 every month. As our ranks grow, we need a platform for the exchange of information and discussion about mesotherapy research. Our goal and hope is that the American Journal of Mesotherapy will be an open forum to share our knowledge and experience in mesotherapy. Like all new methodologies, mesotherapy has been criticized by some, possibly due to a general lack of knowledge and perhaps, in some cases, the use of unproven methods by individuals lacking the necessary training and experience. Our mission is to publish scientific research in mesotherapy to improve knowledge and practice in this field. Help us reach our goal by subscribing to the Journal. Any income generated will be used for financial support of research in mesotherapy. I extend our gratitude toward the Editorial Board for their support and encouragement. Again, this journal is open for all of us. Aleksy Dobradin, MD
Continental USA - RRP: $89 and $139 USD – YOU GET 10% OFF YOUR MW PRICE
1 year subscription $80.10 USD 2 year subscription $125.10 USD \
Outside Continental USA - RRP: $124 and $198 USD – YOU GET 10% OFF YOUR MW PRICE
1 year subscription $111.60 USD 2 year subscription $178.20 USD
Internet Only Subscription - RRP: $69.50 and $111.00 USD – YOU GET 10% OFF YOUMW PRICE 1 year subscription $62.55 USD 2 year subscription $100.00 USD
