Tinea Capitis

What causes tinea capitis and who is at risk?

Tinea capitis (also called ringworm of the scalp) is a skin disorder that usually affects only children younger than age ten. It can be persistent and is highly contagious; it is not due to an infection by a worm. Ringworm gets its name from the appearance of the round lesions that occur on the scalp.

The fungi that cause tinea infections thrive in warm, moist areas. You have an increased risk for tinea infection if you have poor hygiene, prolonged wetness of the skin (such as from sweating), and minor skin or scalp injuries.

Other types of tinea infections that can occur include tinea corporis (on the body), tinea cruris ('jock itch' in the groin area), tinea barbae (beard), tinea unguium (nails), or tinea pedis ('athletes' foot).

Tinea infections are contagious. You can catch the skin disorder if you come into direct contact with someone who has the condition, or if you touch contaminated items such as combs, hats, clothing, or similar surfaces. The infection can enter through cut or broken skin. The infection can also be spread by pets, particularly cats or dogs. Horses, pigs and cows can transmit ringworm, too. Missing patches of hair on an animal may be a sign of ringworm, and the animal should be seen by a veterinarian.

Good general hygiene is important in the prevention and treatment of all tinea infections. The scalp should be shampooed regularly, especially after haircuts.

Avoid contact with infected pets or individuals. Headgear, combs, brushes, and similar items should not be shared. Children sharing sleeping mats at daycare have contracted tinea capitis, as well.

Symptoms

Symptoms of tinea capitis include round, scaly lesions on the scalp. These areas may be red or swollen (inflamed). The patient may also have areas that appear bald (alopecia), due to hair that has broken off. There may be small black dots on the scalp.

Itching of the scalp may be slight, or may not occur at all. Sometimes, there may be pus-filled lesions on the scalp (kerions).

Diagnosis

The diagnosis is suspected primarily based on the appearance of the scalp. A skin lesion biopsy with microscopic examination or culture may show dermatophytes. This test is often not necessary to diagnose tinea capitis. A Wood's lamp test may be performed to confirm the presence of a fungal scalp infection.

Call your doctor if:

Call for an appointment with your health care provider if you have symptoms of tinea capitis. Home care remedies do not effectively treat tinea capitis. Longer-term , prescription oral medications will probably be needed.

Treatment Options

Anti-fungal medications, taken by mouth, are used to treat the infection of the scalp. Agents applied topically, like creams, are not effective, as they do not penetrate to the fungal infection in the hair shaft.

Griseofulvin may be used for 6 to 8 weeks of therapy. Patients should take griseofulvin with a fatty meal to enhance absorption. Griseofulvin may lead to nausea or upset stomach in children.

Terbinafine, itraconazole, and fluconazole are other orally available antifungal options for tinea capitis; however, treatment periods for some of these drugs may be shorter, from 2 to 4 weeks, which may aid in compliance. Both ketoconazole and fluconazole may also cause stomach upset in children.

Many antifungal medications are available generically. Griseofulvin, terbinafine, itraconazole, and fluconazole are all available in the generic form, and because these medications are taken for prolonged periods of time, generic substitutes may be more cost effective.

For tinea capitis caused by Microsporum spp., griseofulvin has been shown to be superior for treatment in a 2013 meta-analysis (Gupta, et al), whereas terbinafine was superior for Trichophyton spp. infection.

In July, 2013 the FDA issued a drug safety communication warning for oral ketoconazole (Nizoral) about the possibility of severe liver injuries, adrenal gland problems and harmful drug interactions with other medications. As a result, ketoconazole oral tablets should not be a first-line treatment for any fungal infection. Oral ketoconazole should be used for the treatment of certain fungal infections, known as endemic mycoses, only when alternative antifungal therapies are not available or tolerated. The topical formulations of ketoconazole have not been associated with liver damage, adrenal problems, or drug interactions. These formulations include creams, shampoos, foams, and gels applied to the skin, unlike the ketoconazole (Nizoral) tablets, which are taken by mouth.

Oral Antifungal Treatments for Tinea Capitis

Male Pattern Baldness

What causes male pattern baldness and who is at risk?

Male pattern baldness is caused by hormones and genetic predisposition.

Hair grows about an inch every couple of months. Each hair grows for 2 to 6 years, remains at that length for a short period, then falls out. A new hair soon begins growing in its place. At any one time, about 85% of the hair on your head is in the growing phase and 15% is not.

Each hair sits in a cavity in the skin called a follicle. Baldness in men occurs when the follicle shrinks over time, resulting in shorter and finer hair. The end result is a very small follicle with no hair inside. Ordinarily, hair should grow back. However, in men who are balding, the follicle fails to grow a new hair. Why this occurs is not well understood, but it is related to your genes and male sex hormones. Even though the follicles are small, they remain alive, suggesting the possibility of new growth.

Symptoms

The typical pattern of male baldness begins at the hairline, which gradually recedes to form an "M" shape. The existing hair may become finer and shorter. The hair at the crown also begins to thin. Eventually the top of the hairline meets the thinned crown, leaving a horseshoe pattern of hair around the sides of the head.

Hair loss in patches, diffuse shedding of hair, breaking of hair shafts, or hair loss associated with redness, scaling, pain, or rapid progression could be caused by other conditions.

Diagnosis

Classic male pattern baldness is usually diagnosed based on the appearance and pattern of the hair loss. Any atypical hair loss may be caused by other medical disorders. A skin biopsy or other procedures may be needed to diagnose other disorders that cause loss of hair.

Hair analysis is not accurate for diagnosing nutritional or similar 

Female Pattern Baldness

What causes female pattern baldness and who is at risk?

Hair grows about an inch every couple of months. Each hair grows for 2 to 4 years, remains at that length for a short period, then falls out. A new hair soon begins growing in its place. At any one time, about 85% of the hair on your head is in the growing phase and 15% is in the resting phase.

Baldness occurs when hair falls out but new hair does not grow in its place. The cause of failure to grow new hair in female pattern baldness is not well understood, but it is associated with genetic predisposition, aging, and levels of hormones (particularly androgens, the male sex hormones).

Changes in the levels of androgens can affect hair production. For example, after the hormonal changes that occur during menopause, many women find that the hair on their head has become thinner while facial hair has become coarser.

Female pattern baldness is generally permanent hair loss.

Hair loss can occur in women for reasons other than female pattern baldness, including the following:

Temporary shedding of hair that may occur after surgery, pregnancy or after a major illness. (telogen effluvium).

Breaking of hair (from such things as styling treatments and twisting or pulling of hair)

Patchy areas of total hair loss (alopecia areata - an immune disorder causing temporary hair loss)

After chemotherapy and from some other medications

Certain skin conditions

Hormonal imbalance (excess testosterone or thyroid hormone imbalance)

Iron or vitamin deficiency

Diseases like diabetes or lupus

Hair loss due to these reasons is usually reversible is identified and dealt with correctly.

Symptoms of female pattern baldness

Thinning of hair over the entire head; front-line hair remains. (Hair thinning is different from that of male pattern baldness)

Hair loss at the crown or hairline, mild to moderate

Hair loss rarely progresses to total or near total baldness, as in men.

The typical pattern of female pattern baldness is different from that of male pattern baldness. The hair thins all over the head, but the frontal hairline is maintained. There may be a moderate loss of hair on the crown, but this rarely progresses to total or near baldness as it may in men.

Diagnosis of female pattern baldness

Female pattern baldness is usually diagnosed based on the appearance and pattern of hair loss and by ruling out other causes of hair loss.

A skin biopsy or other procedures may be used to diagnose medical disorders that cause loss of hair.

Hair analysis is not accurate for diagnosing nutritional or similar causes of hair loss, although it may reveal substances such as arsenic or lead.

Your doctor should also check for other causes such as too much male hormones (androgens) or imbalance of other hormones.

Treatment options

The hair loss that results from female pattern baldness is permanent and there is no known preventative. In most cases, it is mild to moderate. No treatment is required if the person is comfortable with her appearance.

Minoxidil applied topically, is the only medicine approved by the United States Food and Drug Administration (FDA) to treat female pattern baldness.

Oral contraceptives are sometimes effective in treating female pattern hair loss due to hyperandrogenemia.

Hair transplants consist of the removal of tiny plugs of hair from areas where the hair is continuing to grow and placing them in areas that are balding. This can cause minor scarring in the donor areas and carries a modest risk for skin infection. The procedure usually requires multiple transplantation sessions and may be expensive. Results, however, are often excellent and permanent.

Suturing of hair pieces to the scalp is not recommended as it can result in scars, infections, and abscess of the scalp. The use of hair implants made of artificial fibers was banned by the FDA because of the high rate of infection.

Hair weaving, hairpieces, or change of hairstyle may disguise hair loss and improve cosmetic appearance. This is often the least expensive and safest method of treating female pattern baldness.

Prognosis

Hair loss in women can be serious and could cause complications such as psychological stress and loss of self-esteem due to change in appearance, as this pattern of hair loss is permanent. It is more acceptable for men to go through hair loss.

See your doctor if:

Hair loss occurs and persists. There might be a treatable medical cause for the loss of hair.

Also if you feel female pattern baldness is present and you want to treat the hair loss; or if hair loss is accompanied by itching, skin irritation, or other symptoms.

Hair Loss: Medications & Treatment Options

Hair loss occurs when hair follicles stop producing hair growth - it is called alopecia.

Hair loss is a normal part of aging. Generally about 100 hairs are lost from your head every day. You may not notice this loss because the average scalp contains about 100,000 hairs. Some people may however experience excessive hair loss.

The normal cycle of hair goes through a phase of growth and rest. Each individual hair survives for an average of three and a half years. The growth phase of hair generally lasts two to three years, during which time it grows about half an inch a month. This growing phase is called anagen. This is followed by a resting phase called telogen, which lasts for about three to four months. Usually in its fourth year the hair falls out and is replaced within 6 months by a new one.

Types of Hair Loss

Pattern Baldness - is inherited or genetic baldness. It is also known as androgenetic alopecia and is caused by the body's failure to produce new hairs, and not due to excessive hair loss. Androgenetic alopecia is generally permanent.

Inherited or "pattern baldness" affects many more men than women. About 25% of men begin to bald by the time they are 30 years old, and about two thirds are either bald or have a balding pattern by age 60.

Male pattern baldness involves a receding hairline and thinning around the crown with eventual bald spots. Ultimately, you may have only a horseshoe ring of hair around the sides. In addition to genes, male pattern baldness seems to require the presence of the male hormone testosterone. Men who do not produce testosterone (because of genetic abnormalities or castration) do not develop this pattern baldness.

Some women also develop a particular pattern of hair loss due to genetics, age or male hormones that tend to increase in women after menopause. The patten is different from that of men. Female pattern baldness involves a thinning throughout the scalp while the frontal hairline remains intact.

In addition to the common male and female patterns, the following are other types of hair loss some of which are temporary:

Alopecia areata - bald patches develop on the scalp, beard, and possibly eyebrows. eyelashes may fall out as well. This is thought to be an autoimmune disease, where the immune system attacks the hair follicles and leads to hair loss on the scalp and other parts of the body. However, the hair follicles are alive so there is potential for hair to regrow when the underlying problem has resolved. Growth may occur even without treatment and even after many years. In most cases hair loss only happens in a few places, leaving a few bare patches. In some cases though, the disease can advance to total loss of hair from the head (alopecia areata totalis) or complete loss of hair on the head, face and body (alopecia areata universalis).

Tinea capitis - is hair loss due to fungal infection of the scalp. This is easily treated with antifungal medicines.

Hormonal changes - an over-active or under-active thyroid gland may cause hair loss. This hair loss stops once the thyroid disease is treated.

Female or male hormone (estrogen and androgen) imbalance can be the cause of hair loss. Once this imbalance is corrected hair loss may stop. Some women may experience hair loss a few months after they've had a baby. This loss is also due to hormonal changes.

Telogen effluvium - is temporary hair loss, which can occur after a serious illness, major surgery or emotional or physical stress.

Anagen effluvium - is hair loss due to treatment with chemotherapy medicines. These medicines target rapidly dividing cells, so affects the actively growing hair cells. Hair grows back after the treatment is finished. This type of hair loss also occurs with radiation therapy but it is localized to the area of treatment. so if treatment is in the hip area you will lose hair in that area but not the hair on your head.

Traction alopecia - certain hairstyles such as when you pull on your hair tightly can cause scarring of the hair follicles. If pulling is stopped before scarring to the scalp then your hair will grow back normally. Nervous habits such as continual hair pulling or scalp rubbing can also cause scarring and ultimately permanent hair loss. Excessive shampooing and blow-drying can also cause hair loss.

Cicatricial or Scarring alopecia - hair loss occurs when inflammation damages and scars the hair follicle and replaces it with scar tissue. The inflammation that destroys the follicle is under the skin surface so affected areas of the scalp may show little signs of inflammation. It is not known what triggers or causes this inflammation. If the inflammation destroys the stem cells and sebaceous glands, then hair loss is permanent.

Diseases - such as diabetes or lupus can cause hair loss.

Trichotillomania - is a psychological condition where the individual has strong urges to pull out their own hair.

Medicines - hair loss can also happen due to medicines such as birth control pills, certain medicines used to treat gout, anticoagulants, antidepressants, etc.

Nutrition - poor nutrition or nourishment can also cause hair loss. Diets, illness, eating disorders would cause poor nutrition.

See your doctor if:

You are losing hair in an atypical pattern.

You are losing hair rapidly or at an early age (for example, in your teens or twenties).

You have any pain or itching associated with the hair loss.

The skin on your scalp under the involved area is red, scaly, or otherwise abnormal.

You have acne, facial hair, or menstrual irregularities.

You are a woman and have male pattern baldness.

You have bald spots on your beard or eyebrows.

You have been gaining weight or have muscle weakness, intolerance to cold temperatures, or fatigue.

Your doctor will take a detailed medical history and will examine the condition of your hair and scalp; this is usually enough to diagnose the nature of your hair loss. Your doctor will also ask questions such as:

Are you losing hair only from your scalp or from other parts of your body as well?

Is there a pattern to the hair loss like a receding hair line, thinning or bald areas on the crown, or is the hair loss throughout your head?

Have you had a recent illness or high fever?

Do you dye your hair?

Do you blow dry your hair? How often?

How often do you shampoo your hair?

What kind of shampoo, hair spray, gel, or other product do you put on your hair?

Have you been under unusual stress lately?

Do you have nervous habits that include hair pulling or scalp rubbing?

Do you have any other symptoms like itching, flaking, or redness of your scalp?

What medications do you take, including over the counter drugs?

Diagnostic tests that may be performed (but are rarely needed) include:

Microscopic examination of a plucked hair

Skin biopsy (if skin changes are present)

Treatment Options For Hair Loss

Treatment depends on the type or reason for hair loss. Effectiveness of these medications may depend on extent of loss and the person's response to a particular medication or procedure.

Hair loss from menopause or childbirth often returns to normal 6 months to 2 years later.

For hair loss caused by illness (such as fever), radiation therapy or chemotherapy, no treatment is necessary. Hair will grow back when illness has ended or the therapy is finished. A wig, hat, or other covering may be desired until the hair grows back.

If a medication is causing hair loss then your doctor may be able to prescribe a different medication to treat your condition (provided an alternative exists).

Pattern Baldness

Although pattern baldness is permanent the following medicines may help slow or prevent the development of common pattern baldness. It can take about 6 months before you see results from these medicines and when you stop using then the former pattern baldness returns.

Propecia (finasteride) is a 5 alpha-reductase inhibitor. It works by inhibiting the conversion of testosterone into 5 alpha-dihydrotestosterone (DHT), a hormone that plays an important role in hair loss. Propecia is a prescription medicine and is only approved for use in men. There are other 5 alpha-reductase inhibitors on the market but Propecia is the only one approved for androgenetic alopecia.

Propecia can cause a decrease in sex drive and sexual function.

Can you treat women's hair loss with a drug used for men?

Hair loss is surprisingly common in women, affecting more than 30 million in the U.S., according to the American Academy of Dermatology. It can start as early as puberty or much later in life. In fact, 38 percent of women 70 and older experience hair loss, in part because hair thickness decreases with age, especially after menopause. The condition often leads to low self-esteem, social anxiety, and self-imposed isolation.

Female pattern hair loss (FPHL) is characterized by thinning over the top of the scalp and sometimes the sides. In men, a male hormone known as an androgen is primarily responsible for hair loss, but the main cause of FPHL appears to be less clear-cut. Women normally produce male hormones too, and in some cases the condition is associated with excessive androgen levels. Other types of hair shedding in women may be related to estrogen loss or significant changes in estrogen levels, as in the postpartum period or in menopause. Hair loss can also result from breakage during hair treatments and styling, certain medication—including hormones—and conditions like iron deficiency, severe dieting, thyroid disease, lupus, and even stress.

Finasteride (Propecia) is approved by the Food and Drug Administration to treat male pattern hair loss (also called androgenetic alopecia). At higher doses, it's also approved to reduce the symptoms of enlarged prostate in men. It works by blocking the enzyme that is responsible for the conversion of testosterone to dihydrotestosterone, the androgen that causes the prostate to enlarge. It also reduces dihydrotestosterone levels in the scalp, which slows hair loss and even increases hair growth. Because finasteride has been effective in controlling male pattern hair loss, it has been used to treat female pattern hair loss, although it has not gained FDA approval for that purpose. Medication prescribed to treat a condition that does not have FDA approval for that use is known as "off-label." Doctors can legally prescribe any medication they deem appropriate for treatment.

"If a woman has female pattern hair loss and elevated androgen levels that we can document, then she is likely to respond to treatments that block or decrease androgens, and finasteride is an option," says Elise A. Olsen, M.D., a professor of dermatology and oncology and director of the Hair Disorders Research and Treatment Center at Duke University Medical Center. "But often we will try it even in women who don't have elevated androgen levels because other treatment options are very limited, and these women may have sensitivity to androgens at the cellular level of the hair follicle that we can't document."

What is the evidence?

The only randomized, double-blind, placebo-controlled trial on this subject involved 137 postmenopausal women with low androgen levels and hair thinning at the front of their scalp. After 12 months, there were no significant differences in hair count between the patients receiving finasteride or a placebo, and both groups continued to lose hair. The authors concluded that finasteride was well-tolerated but did not reduce hair loss in these women.

Another group of researchers studied 48 premenopausal women with FPHL and elevated androgen levels: 36 subjects were randomized to treatment with one of three drugs with anti-androgen effects, including finasteride, and 12 subjects declined treatment but were observed. The study wasn't blinded, meaning that patients and researchers knew which medication was received. After a year, those taking finasteride continued to lose hair.

In contrast, two studies reported some success with finasteride, but neither was randomized, blinded or placebo-controlled. In one, 37 premenopausal women with FPHL but without androgen excess received finasteride along with an oral contraceptive. After 12 months, most of them showed improved hair density, although the contraceptive contained drospirenone, which has anti-androgen actions and may have contributed to that effect. And in a 2010 study, 86 pre- and postmenopausal Asian women with FPHL and normal androgen levels were treated with finasteride for 12 months, resulting in slight increases in hair density for 57 women, moderate increases in 10 women, and more substantial increases for four women. Anecdotal reports and small, uncontrolled trials have also noted beneficial results with hair loss in pre- and postmenopausal women with or without increased androgen levels.

What are the risks and precautions?

Birth defects. Our medical consultants advise against the use of finasteride during pregnancy or in women who may become pregnant. Finasteride can cause genital abnormalities in the male fetus. Women who are pregnant or possibly pregnant shouldn't even handle crushed or broken tablets of finasteride because it can be absorbed through the skin.

Side effects. Few adverse reactions have been noted in women receiving finasteride. Increased body hair, sweating and hot flashes, and headaches were reported during clinical studies of women receiving finasteride, but those effects were also noted in women not receiving the medication. (See here for a list of side effects reported in men.)

Liver concerns. Finasteride should be used with caution by people with liver abnormalities because the drug is extensively metabolized in the organ.

Hair loss: What other options can you try?

Treat the underlying problem. The average person loses 50 to 100 hairs a day. Consult your doctor or a dermatologist if your hair is shedding in larger amounts, thinning, or falling out. Proper diagnosis and treatment may help slow hair loss. You should be referred to both a dermatologist and an endocrinologist to be screened for thyroid disease, iron deficiency, skin disorders, lupus, and other possible causes. If your hair loss is accompanied by excess facial and body hair, abnormal periods, or adult acne, your androgen levels should be tested.

Review all medication and supplements you are taking with your doctor. You may need to discontinue or change a drug if it contributes to hair loss. That may include certain antidepressants, antithyroid medicines, blood thinners, drugs for high blood pressure or heart problems, hormones, cholesterol-lowering medications, nonsteroidal anti-inflammatories such as ibuprofen (Advil, Motrin and generics) and naproxen (Aleve and generics), and retinoids (e.g., acitretin, isotretinoin).

Eat adequately. Certain diets—especially those that skimp on protein—can trigger hair loss.

Use the first-line treatment. Minoxidil (Rogaine and generic) 2 percent, an over-the-counter solution that's applied to the scalp, is currently the only FDA-approved medication for female pattern hair loss. Experts recommend trying the 2 or 5 percent version for 12 months before judging its effectiveness, although benefits may appear sooner. "Women use it for a month or two and assume it doesn't work," says Maria Hordinsky, M.D., a professor and chairwoman of the department of dermatology at the University of Minnesota. "But if you treat long enough, you can get results in most people." Your doctor may add an oral drug with anti-androgen effects, such as finasteride or spironolactone, if your hair loss appears to be androgen-related.

Change your hair-care practices. Avoid styles and treatments that can damage hair, including braiding, cornrows, tight ponytails, rollers, bleaching, coloring, chemical straightening or waving, blow-drying, and hot combs.

Cover your losses. Tinted powders, lotions, and sprays can camouflage hair thinning, as can extensions, hairpieces and wigs. But choose items that gently attach to the scalp via loose braids, pins, or simple placement. "Glues can be damaging," says Amy McMichael, M.D., a professor of dermatology at Wake Forest University School of Medicine in North Carolina. Volumizing shampoos swell the hair shaft, making it appear wider, but may cause breakage of fragile or damaged hair, she warns. Hair-restoration surgery permanently transplants hair from thicker to thinning areas of the scalp. "If you combine that with medication, you get a nice effect of slowing hair loss and increasing density," McMichael says.

Bottom line. Finasteride has been used to treat female pattern hair loss and is reported to be effective for some women, but to date there is no good evidence from well-designed clinical trials to support its use for that purpose. Our advice: If you're a woman with thinning hair or significant hair loss, talk with your doctor about a referral to a specialist to look for underlying causes and approved treatments, such as minoxidil (Rogaine and generic). Finasteride probably plays little or no role in reversing hair loss in women with normal or low androgen levels.

This off-label drug use report is made possible through a collaboration between Consumer Reports Best Buy Drugs and the American Society of Health-System Pharmacists. This is the 24th in a series based on professional reports prepared by ASHP.

These materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by a multistate settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

Best Hair Loss Treatment For Men: A No-Nonsense Guide

1 out of 4 — that’s the average number of men who start losing their hair to Male Pattern Baldness before the age of 30.

best hair loss treatment for men

This is it.

You are not alone brother, it’s nothing out of the ordinary.

In fact, it’s quite common.

Welcome to the club.

Hair loss is a different experience for everyone. If you don’t care about losing hair, that’s perfectly fine. It’s not always worth stressing about.

Do you have a defined jaw line, a strong brow ridge, a nice head shape and grow a decent amount of facial hair? Then hair loss also may not be a big deal for you at all. You won’t lose much (if any) points in the looks department.

But while this holds true for those men, let’s not forget the other side of the coin – men who just don’t look very attractive if they go bald. If you consider yourself a part of this group, then you might want to consider some sort of treatment, particularly if you are still young (ish).

I firmly believe there is no single best answer for everyone. You have to learn what works best for you. As you may well know, everyone’s different.

So let’s pretend you decided to take action and seek treatment for your hair loss. Do a search on Google or Amazon. What do you find?

Let me spoil it for you; you will find literally tons of snake oil, and all possible natural ways how to treat hair loss, that don’t do anything, except waste your time.

Hair loss treatment for men

The hairiness hair washing and drying, and the frequent use of water hardness or added chlorine in sterile hair bath process leads to dry hair and split ends and hair loss with the knowledge that is reasonable for the average number of hair in the head almost 150,000 hair average. What is causing drought and precipitation problems and embrittlement of the hair is the frequent use of electric hair dryer or Curlers electric hair, frequent Trddk on swimming pools or even frequent washing hair in the same detergent, and that hair is affected by weather factors surrounding such as sunlight, wind, leading to dryness and the occurrence of some of the problems . Hair cut when cutting the hair, it is changing the outer part of it, and this is not conducive to hair growth or strengthen it, but in some cases increases the hair thickness, and the longer the problem of loss of men felt a chronic problem in the Arab world which acquires men interesting to remedy them, the main reason for the loss hair is genetic, and therefore all methods of treatment may extend the life of the hair, but it will not prevent them from falling in the end hair loss treatment for hair loss treatment more than one way, including: (medicines, creams and sprays and needles treatment. Laser treatment. deceptive treatment, and here the patient spraying some of the material that gives the hair thickness. surgical treatment. the process of hair transplantation. redistribute the scalp. The main reason for hair loss is Jenny and Orathi, all treatments with drugs or based paints (creams) or massage (massage) or laser may extend the life of the hair (perhaps for years), but it will not prevent them from falling a result, the technology has been up to tomorrow the change-causing genes for hair loss before it occurs, which can fundamentally solve the problem, but to sight a distant tomorrow. The surgery shall lie in a roundabout way the problem will come to explain. Medicines and creams and sprays and needles these treatments retard hair loss does not prevent him treatment, and proceed from that some necessary for hair growth and health of material insurance, leading to maintain it for as long as possible, doctors also noted that when their use of drugs high blood pressure, for example, the case of hair loss improved grew tired and turned these medications for goals and used them for hair. Laser treatment stems from the principle of stimulating the skin and blood vessels of the breadth and secure the necessary food for the hair, to reduce hair loss. But the laser will not be able to change genes. Deceptive or placebo treatment here is the patient, for example, by spraying some subsequent articles that give hair thickness, and thus provide the impression that the hair thicker. As well as specialist Tattoos may resort to draw some lines heavily, or have the specialist hair decorating, gluing some tuft of hair remaining hair or even paste on the skin. Surgical treatment and eradication of hair transplant, hair hair. Remove a portion of the scalp while keeping contact with Bhraianha, and modulating place to cover the curl area. Use balloons to enlarge the scalp. The hair transplant hair Omar specified genetically, and varies by location, for example, it is well known that the hair above the temple area or neck-old is much longer than the hair on the top of the head. So when we want to eradicate some of the hair transplant, we usually take it from the hairy area above the neck, job by the removal of a piece of skin Hairy 10-15 cm long and 1-2 cm width, then close the wound by Altkotaib so as not to leave a blank spot above the neck. And then they cut what Astosalnah to very small units, each containing a single hair and even three hairs, then make a small cracks and stuck in the bald area and the plant where these units, and is done under local anesthesia, and we can implant up to 5000 hair in a single session. It must be pointed out that the transplanted hair density much lighter than the natural hair density; for it is impossible, we make incisions too close to plant units as it is not able sufficient number of hair secure if we could make a small and close incisions, the piece that eradicates for transplantation believes comercial space perhaps five times area, and thus density of transplanted hair less five times at least. This transplanted hair due to the growth of natural poetry at the top of the neck, and lasts as genes hair of the top of the neck, are the story and washed without any warned natural poetry, while in the first months after the transplant, observes the effects of cracks in the form of small red lines on the scalp to disappear after that, and the last about 4-5 hours of surgery, under local anesthesia. Redistribution of scalp wounds also can in special cases, cut off part of the scalp of the hairy area, while preserving the arteries that feed connected to the veins of the rest of the head, and then change the place and managed, for example, from the temple area or neck forward to replace the bald part in the head about the same size, and here are the same density as this truncated segment covered the area, but in a different location. Use balloons balloon implants of silicone material empty under a dense scalp hair, then injected periodically for a month or two months with water by a needle through the skin. As a final size, it may be extended scalp surrounding it by a large margin. This expansion has, the surgeon will allow the removal of the bald area and then provide us with coverage including the scalp extended. And be a little less intensity than the rest of the head, a relatively modern way, believes sufficient density but take place in two stages, each stage requires half an hour to an hour, under local or general anesthetic. Quick ways to treat hair loss Wash hair twice a week in winter and three times a summer, using soap and shampoo, hairdressing using olive oil, aloe vera. Wash oily hair three times a week using a shampoo that contains lemon or eggs. Dry hair washed once a week using a shampoo that contains oil. Add castor oil to refill shampoo; it intensifies and strengthens hair. Watercress juice mixture (the benefits of watercress for men), onions, olive oil, cumin powder and pomade him. Boil the peel garlic with olive oil. Boil patience with olive oil plant prevents hair loss. Grinding fig leaves and add to boiling oil with a little rose water and massage the scalp once a day. Eating onions; it strengthens the hair and prevents hair loss. Wash hair resulting from the boiling water thermos In the end, each state solution, and the plastic surgeon is qualified to conduct and choose between them. It will not be among you dare to hold one of these surgeries, including Vliqtna has. Vemodh balding currently in vogue, and some thick hair owners Adzouna to keep up with this fashion. Note: The subject of hair loss treatment for men is not a healthy reference, please see your doctor.

Hair Loss: The Science of Hair

What alternative choices do individuals have for hair loss?

There ar several choices and various cosmetic treatments for hair loss. a number of these ar listed here and embrace hair-fiber powders, hairpieces, artificial wigs, human hair wigs, hair extensions, hair weaves, laser, and surgery.

Hair-fiber powders: coloured, powdery fiber sprinkles ar commercially offered and will work to camouflage hairless areas. These coloured sprinkles have special properties that facilitate them attach to hair and provides a fuller look. Toppik is one manufacturer of those merchandise and might be found on-line. These cosmetic merchandise ar offered while not a prescription, ar fairly cheap ($20-$40 range), and quite safe with stripped-down risk. typically these is also utilized in addition to medical treatments like Loniten, Propecia, and hair transplants, and that they live} a good temporary measure to tide one over for special occasions.
A good daily multivitamin pill containing atomic number 30, vitamin B, folate, iron, and metal could be a affordable alternative, though there's no smart proof that vitamins have any meaningful  profit in phalacrosis. Newer studies counsel that viosterol is also somewhat useful and price considering. Specific victuals and mineral deficiencies like iron or cobalamin is also diagnosed by blood tests and treated.

Hair is way additional advanced than it seems on the surface. we have a tendency to all grasp that it not solely plays an important role within the look of each men and girls, however it conjointly helps to transmit sensory info in addition as produce gender identification.

The Origins of Hair
By week 22, a developing foetus has all of its hair follicles shaped. At this stage of life there ar concerning five million hair follicles on the body. There ar a complete of 1 million on the pinnacle, with 100 thousand of these follicles residing on the scalp. this is often the biggest variety of hair follicles somebody's can ever have, since we have a tendency to don't generate new hair follicles anytime throughout the course of our lives.

Most people can notice that the density of scalp hair is reduced as they grow from childhood to adulthood. The reason: Our scalps expand as we have a tendency to grow.


Hair Follicles
Hair has 2 distinct structures - 1st, the vesicle itself, that resides within the skin, and second, the shaft, that is what's visible on top of the scalp.

The follicle could be a tunnel-like phase of the cuticle that extends down into the corium. The structure contains many layers that every one have separate functions. At the bottom of the vesicle is that the papilla, that contains capillaries, or small blood vessels that nourish the cells. The living a {part of} the hair is that the terribly bottom part encompassing the papilla, known as the bulb. The cells of the bulb divide each twenty three to seventy two hours, remarkably quicker than the other cell within the body.

Two sheaths, associate degree inner and outer sheath, surround the vesicle. These structures defend and type the growing hair shaft. The inner sheath follows the hair shaft and ends below the gap of a greasy (oil) secretor, associate degreed typically an apocrine (scent) secretor. The outer sheath continues all the high to the secretor. A muscle known as associate degree erector pili muscle attaches below the secretor to a fibrous layer round the outer sheath. once this muscle contracts, it causes the hair to square up that conjointly causes the glandulae sebaceae to secrete oil.

The glandulae sebaceae is significant as a result of it produces secretion, that conditions the hair and skin. once pubescence our body produces additional secretion however as we have a tendency to age we start to create less secretion. ladies have so much less secretion production than men do as they age.

What alternative choices do individuals have for hair loss? There area unit several choices and different cosmetic treatments for hair loss. a number of these area unit listed here and embrace hair-fiber powders, hairpieces, artificial wigs, human hair wigs, hair extensions, hair weaves, laser, and surgery. Hair-fiber powders: coloured, powdery fiber sprinkles area unit commercially offered and should work to camouflage hairless areas. These coloured sprinkles have special properties that facilitate them attach to hair and provides a fuller look. Toppik is one manufacturer of those merchandise and may be found on-line. These cosmetic merchandise area unit offered while not a prescription, area unit fairly cheap ($20-$40 range), and quite safe with lowest risk. typically these is also utilized in addition to medical treatments like minoxidil, Propecia, and hair transplants, and that they live} a good temporary measure to tide one over for special occasions. A good daily vitamin pill containing Zn, vitamin B, folate, iron, and Ca could be a affordable alternative, though there's no sensible proof that vitamins have any meaning profit in phalacrosis. Newer studies counsel that D is also somewhat useful and price considering. Specific nourishment and mineral deficiencies like iron or vitamin B complex is also diagnosed by blood tests and treated. Multiple vitamins, as well as vitamin B complex, are promoted for hair growth, however solid scientific studies for several of those claims area unit lacking. whereas taking vitamin B complex and alternative supplements marketed for hair, skin, and nails most likely will not worsen something, it's going to additionally not essentially facilitate the case. Therefore, publicized hair-regrowth supplements ought to be approached with gentle caution. It may appear a peculiar yankee vainness that men have in-boxes choked with hair loss treatment offers and pay billions of bucks on hair loss treatments every year. Not so. As Gersh Kuntzman illustrates in his book Hair! Mankind's Historic Quest to finish hairlessness, chrome-dome anxiety has tormented United States for ages. Caesar's laurel wreaths? Classic red herring, Kuntzman says. Baldness is biblical, too -- from the Maccabees to Samson and Delilah (a story Kuntzman calls "practically an advert for Propecia") -- the testament is affected by hair loss. If there'd been email some time past, it is a sensible bet prophet would be torturing over whether or not or to not get minoxidil on-line currently. For as long as men are fretting over their increasing foreheads, they have been scrounging for hair loss treatments. From hippo fat pomades to the piddle of young foals, history is choked with just-so-crazy-they-might-work concoctions. They didn’t work. And a fast Googling reveals that the majority of the merchandise and services marketed nowadays area unit solely slightly less absurd. In reality, there’s a awfully restricted range of effective treatments for male pattern hairlessness. only if common fraction of yankee men can expertise a big level of cutting by the age of thirty five, it's price running through the choices.

There area unit several choices and different cosmetic treatments for hair loss. a number of these area unit listed here and embrace hair-fiber powders, hairpieces, artificial wigs, human hair wigs, hair extensions, hair weaves, laser, and surgery.

Hair-fiber powders: coloured, powdery fiber sprinkles area unit commercially offered and should work to camouflage hairless areas. These coloured sprinkles have special properties that facilitate them attach to hair and provides a fuller look. Toppik is one manufacturer of those merchandise and may be found on-line. These cosmetic merchandise area unit offered while not a prescription, area unit fairly cheap ($20-$40 range), and quite safe with lowest risk. typically these is also utilized in addition to medical treatments like minoxidil, Propecia, and hair transplants, and that they live} a good temporary measure to tide one over for special occasions.
A good daily vitamin pill containing Zn, vitamin B, folate, iron, and Ca could be a affordable alternative, though there's no sensible proof that vitamins have any meaning profit in phalacrosis. Newer studies counsel that D is also somewhat useful and price considering. Specific nourishment and mineral deficiencies like iron or vitamin B complex is also diagnosed by blood tests and treated.

Multiple vitamins, as well as vitamin B complex, are promoted for hair growth, however solid scientific studies for several of those claims area unit lacking. whereas taking vitamin B complex and alternative supplements marketed for hair, skin, and nails most likely will not worsen something, it's going to additionally not essentially facilitate the case. Therefore, publicized  hair-regrowth supplements ought to be approached with gentle caution.


It may appear a peculiar yankee vainness that men have in-boxes choked with hair loss treatment offers and pay billions of bucks on hair loss treatments every year. Not so. As Gersh Kuntzman illustrates in his book Hair! Mankind's Historic Quest to finish hairlessness, chrome-dome anxiety has tormented United States for ages. Caesar's laurel wreaths? Classic red herring, Kuntzman says.

Baldness is biblical, too -- from the Maccabees to Samson and Delilah (a story Kuntzman calls "practically an advert for Propecia") -- the testament is affected by hair loss. If there'd been email some time past, it is a sensible bet prophet would be torturing over whether or not or to not get minoxidil on-line currently.

For as long as men are fretting over their increasing foreheads, they have been scrounging for hair loss treatments. From hippo fat pomades to the piddle of young foals, history is choked with just-so-crazy-they-might-work concoctions. They didn’t work. And a fast Googling reveals that the majority of the merchandise and services marketed nowadays area unit solely slightly less absurd.

In reality, there’s a awfully restricted range of effective treatments for male pattern hairlessness. only if common fraction of yankee men can expertise a big level of cutting by the age of thirty five, it's price running through the choices.

What vitamins are good for hair loss?

What alternative choices do individuals have for hair loss?

There area unit several choices and different cosmetic treatments for hair loss. a number of these area unit listed here and embody hair-fiber powders, hairpieces, artificial wigs, human hair wigs, hair extensions, hair weaves, laser, and surgery.

Hair-fiber powders: coloured, powdery fiber sprinkles area unit commercially out there and should work to camouflage hairless areas. These coloured sprinkles have special properties that facilitate them attach to hair and provides a fuller look. Toppik is one manufacturer of those merchandise and might be found on-line. These cosmetic merchandise area unit out there while not a prescription, area unit fairly cheap ($20-$40 range), and quite safe with stripped-down risk. usually these could also be employed in addition to medical treatments like vasodilative, Propecia, and hair transplants, and that they live} a good temporary measure to tide one over for special occasions.
A good daily vitamin pill containing metal, vitamin B, folate, iron, and atomic number 20 may be a cheap alternative, though there's no smart proof that vitamins have any purposeful profit in phalacrosis. Newer studies counsel that vitamin D could also be somewhat useful and value considering. Specific victuals and mineral deficiencies like iron or vitamin B12 could also be diagnosed by blood tests and treated.

Multiple vitamins, together with vitamin B complex, are promoted for hair growth, however solid scientific studies for several of those claims area unit lacking. whereas taking vitamin B complex and alternative supplements marketed for hair, skin, and nails most likely will not worsen something, it's going to conjointly not essentially facilitate true. Therefore, publicized  hair-regrowth supplements ought to be approached with delicate caution.


Can unquiet scalp cause hair loss?

Itchy scalp might cause delicate, reversible hair loss. Causes might embody dermatitis (dandruff). Treatments might embody medicated shampoos like ketoconazole (Nizoral), over-the-counter dandruff shampoos, and topical steroid creams and lotions to assist decrease itch.


How do individuals forestall hair loss?

Hair-loss bar depends on the underlying cause. smart hair hygiene with regular shampooing may be a basic step however is perhaps of very little profit. smart nutrition, particularly adequate levels of iron and B complex, is helpful. Treatment of underlying medical conditions like thyroid malady, anemia, and secretion imbalances might helpful in bar

What different choices do individuals have for hair loss?

What different choices do individuals have for hair loss?

There ar several choices and different cosmetic treatments for hair loss. a number of these ar listed here and embrace hair-fiber powders, hairpieces, artificial wigs, human hair wigs, hair extensions, hair weaves, laser, and surgery.

Hair-fiber powders: coloured, powdery fiber sprinkles ar commercially out there and should work to camouflage hairless areas. These coloured sprinkles have special properties that facilitate them attach to hair and provides a fuller look. Toppik is one manufacturer of those product and may be found on-line. These cosmetic product ar out there while not a prescription, ar fairly cheap ($20-$40 range), and quite safe with marginal risk. typically these could also be employed in addition to medical treatments like Rogaine, Propecia, and hair transplants, and that they area unit} an excellent temporary measure to tide one over for special occasions.
Hairpieces: Among the time-honored ways that to feature hair briefly ar hairpieces or hair weaving, within which a mesh is connected to the remaining hair and artificial or human hair of comparable color and texture is woven  with existing hair. Quality varies significantly with price; conjointly, hairpieces and weaves might stretch, oxidize, and loosen.
Surgery or hair transplants: Surgical hair restoration approaches embrace numerous versions of hair transplantation (taking hair from the rear and putt it close to the front) or scalp reduction (cutting away bald areas and sewing the remainder together). Transplant procedures have improved greatly in recent years. they'll manufacture way more enticing and natural-looking results than older ways that generally leave a "checkerboard" or hair plug look. several transplant patients currently take Propecia to take care of or keep what they've transplanted. once considering a hair transplant, check the surgeon's credentials and skill fastidiously. Micrografts ar a number of the most recent techniques whereby surgeons transplant single one to 2 hair follicles. Hair transplants could also be terribly dearly-won and long procedures travel wide anyplace from $1,000-$20,000, betting on the amount of hair grafts transplanted. Typically, five hundred or additional hairs could also be transplanted in an exceedingly session

What treatment is there for hair loss in men?

What treatment is there for hair loss in men?

There are very few scientifically proven and FDA-approved treatments for hair loss. There are thousands of unproven claims and products to help with hair regrowth. Many conditioners, shampoos, vitamins, and other products claim to help hair grow in some unspecified way. Nioxin has been a popular brand of shampoo for hair loss, but there is no definite evidence showing it is any more effective than regular shampoos. These products are usually harmless but generally not scientifically proven and therefore potentially useless. To slow down hair loss, there are at least four potentially effective, basic options. These include medications like Minoxidil, and Propecia, which are for long-term use. Stopping these drugs does not seem to worsen or exacerbate the prior hair loss. The patient will simply revert to the state he would have been in had he never started treatment.

• Minoxidil (Rogaine): This topical medication is available over the counter, and no prescription is required. It can be used in men and women. It works best on the crown, less on the frontal region. Minoxidil is available as a 2% solution, 4% solution, an extra-strength 5% solution, and a new foam or mousse preparation. Rogaine may grow a little hair, but it's better at holding onto what's still there. There are few side effects with Rogaine. The main problem with this treatment is the need to keep applying it once or twice daily, and most men get tired of it after a while. In addition, minoxidil tends to work less well on the front of the head, which is where baldness bothers most men. Inadvertent application to the face or neck skin can cause unwanted hair growth in those areas.
• Finasteride (Propecia): This medication is FDA approved for use in only men with androgenic hair loss. Finasteride is in a class of medications called 5-alpha reductase inhibitors. It is thought to help reduce hair loss by blocking the action of natural hormones in scalp hair follicles. Propecia is a lower-dose version of a commercially available drug called Proscar that helps shrink enlarged prostates in middle-aged and older men. Women of child-bearing potential should avoid finasteride. Propecia 1 mg tablets are available by prescription and taken once daily. Propecia may grow and thicken hair to some extent for some people, but its main use is to keep (maintain) hair that's still there. Studies have shown that this medication works well in some types of hair loss and must be used for about six to 12 months before full effects are determined. This medication does not "work" in days to weeks, and its onset of visible improvement tends to be gradual. It may be best for men who still have enough hair to retain but also can help some regrow hair. Possible but very unlikely side effects include impotence or a decreased sex drive (libido). Studies have shown that these side effects were possibly slightly more common than seen in the general population and are reversible when the drug is stopped. The cost is about $70-$100/month, which is generally not reimbursed by most health insurers.
• A group of topical medications called prostaglandin analogs have recently began undergoing testing for potential hair regrowth. They may be used in men and women. These drugs are not currently FDA approved for scalp hair loss. Currently, these are primarily used for eyelash enhancement. One of the new medications is calledbimatoprost (Latisse). Further testing and studies are required to assess the efficacy of these products in scalp hair loss. Bimatoprost solution is sometimes used off-label for help in selected cases of hair loss. It is currently FDA approved for cosmetic eyelash enhancement. Studies have shown it can treat hypotrichosis (short or sparse) of the eyelashes by increasing their growth, including length, thickness, and darkness. This medication is also commercially available as Lumigan, which is used to treat glaucoma. It is not known exactly how this medication works in hair regrowth, but it is thought to lengthen the anagen phase (active phase) of hair growth. Interestingly, during routine medical use of Lumigan eyedrops for glaucoma patients, it was serendipitously found that eyelashes got longer and thicker in many users. This led to clinical trials and the approval of cosmetic use of Latisse for eyelashes

What is traction alopecia?

What is traction alopecia?

This is atiny low or localized hair loss space caused by repetitive or persistent pull or traction on hair roots. Tight braids and ponytails will pull exhausting enough on hairs to create them fall out. If this happens, it is best to decide on hairstyles that place less tension on hair. the earlier this can be done the higher to avoid permanent injury.


What is trichotillomania?

This refers to the habit of somebody voluntarily pull at their own hairs or twisting them, typically while not realizing it. The scalp and eyelashes ar typically affected. in contrast to alopecia patches, that ar utterly swish, hair patches in cacoethes show broken-off hairs. Treatment is usually entirely behavioural. One must notice the behavior and so consciously stop. Severe or resistant cases could need stress substance with a expert or scientist or medical treatment with a specialist. many antidepressant drug or anxiety medications are shown to assist with this condition.


What is tinea capitis?

Tinea is that the medical word for zymosis, and capitis means that head. tinea is zymosis of the scalp that for the foremost half affects school-age kids. tinea is a lot of common in African or African-American scalps. This condition is rare in healthy adults. Bald spots typically show broken-off hairs and is amid a eczema. Oral antifungals will penetrate the hair roots and cure the infection, once that hair grows back. Sharing hats or combs and brushes could transmit tinea.


What is generalized (diffuse) hair loss?

This is associate degree overall hair cutting while not specific bald spots or patterns. whereas this kind of hair loss might not be noticeable to others, typically the individual can feel their hair isn't as thick or full because it antecedently was. Common conditions during this class ar

telogen emission (rapid shedding once giving birth, fever, or fulminant weight loss);

Hair loss facts

Hair loss may be a quite common condition and affects the majority at your time in their lives.
Hair loss from breakage of the hair shaft is completely different than hair loss from decreased  hair growth.
Androgenetic hair loss is seen in each men and girls however is worse in men.
Thyroid illness, anemia, supermolecule deficiency, and low sustenance levels might cause hair loss.
Alopecia areata may be a comparatively common reason behind hair loss that sometimes resolves on its own.
Medications indicated for hair regrowth embrace Rogaine (Rogaine) and finasteride (Propecia).
Prevention of hair loss includes sensible hair hygiene, regular shampooing, and sensible nutrition.
Medical health screening for hair loss might embrace blood tests like complete blood count (CBC), iron level, vitamin B, and thyroid perform tests (TFT).

Pluck hair in a specific pattern to grow new hair: Hair six times thicker in mice

On the off chance that there's a cure for male example sparseness, it may hurt a bit. A group drove by USC Undifferentiated organism Chief Agent Cheng-Ming Chuong has exhibited that by culling 200 hairs in a particular example and thickness, they can impel up to 1,200 substitution hairs to develop in a mouse. These outcomes are distributed in the April 9 release of the diary Cell.

"It is a decent sample of how essential exploration can prompt a work with potential translational worth," said Chuong, who is an educator of pathology at the Keck Institute of Prescription of USC. "The work prompts potential new focuses for treating alopecia, a type of balding."

The study started several years prior when first creator and going by researcher Chih-Chiang Chen touched base at USC from National Yang-Ming College and Veterans General Healing center, Taiwan. As a dermatologist, Chen realized that hair follicle damage influences its adjoining surroundings, and the Chuong lab had effectively settled that this environment thus can impact hair recovery. In view of this consolidated learning, they contemplated that they may have the capacity to utilize the earth to initiate more follicles.

To test this idea, Chen concocted a rich system to cull 200 hair follicles, one by one, in distinctive setups on the back of a mouse. While culling the hairs in a low-thickness design from a range surpassing six millimeters in measurement, no hairs recovered. Notwithstanding, higher-thickness culling from roundabout territories with measurements somewhere around three and five millimeters set off the recovery of somewhere around 450 and 1,300 hairs, including ones outside of the culled district.

Working with Arthur D. Lander from the College of California, Irvine, the group demonstrated that this regenerative procedure depends on the rule of "majority detecting," which characterizes how a framework reacts to jolts that influence some, yet not all individuals. For this situation, majority detecting underlies how the hair follicle framework reacts to the culling of some, however not all hairs.

Through sub-atomic examinations, the group demonstrated that these culled follicles sign pain by discharging incendiary proteins, which enlist safe cells to hurry to the site of the harm. These invulnerable cells then discharge flagging particles, for example, tumor rot element alpha (TNF-α), which, at a sure focus, convey to both culled and unplucked follicles that it's a great opportunity to develop hair.

"The ramifications of the work is that parallel procedures might likewise exist in the physiological or pathogenic procedures of different organs, despite the fact that they are not as effectively seen as hair recovery," said Chuong

Scientists identify proteins crucial to loss of hearing

Almost 40 million Americans suffer from hearing loss. Right now, there is no way to reverse this condition, largely because auditory hair cells, which sense sound and relay that information to the brain, do not regenerate.

A new study led by scientists at the University of Maryland School of Medicine (UM SOM) has found a key clue to how these hair cells develop. The current study identified a new role for a particular group of proteins, known as RFX transcription factors, in the development and survival of the hair cells.

"This discovery opens up new avenues, not only for understanding the genetics of hearing, but also, eventually for treating deafness," said the principal investigator, Ronna P. Hertzano, MD, PhD, Assistant Professor of Otorhinolaryngology-Head & Neck Surgery at the UM SOM.

The study appeared in the latest issue of the journal Nature Communications. The work was done in collaboration with scientists at several institutions, among them Ran Elkon, PhD, an Assistant Professor and computational biologist at the Sackler School of Medicine at Tel Aviv University in Israel.

Hertzano and her colleagues used mice whose auditory hair cells glow with a green fluorescent protein, allowing the cells to be identified from other kinds of cells. They then used next generation sequencing -- a state-of-the-art method to rapidly measure gene expression -- to sequence and quantify the thousands of genes that are expressed in hair cells, in comparison with other cells in the ear. As they generated this catalogue of genes, they were searching for key regulators of genes for hair cells. Such regulators could help researchers eventually develop techniques to regenerate hair cells. The key regulator they identified were the RFX transcription factors.

The scientists then moved on to study mice which had been genetically altered so that their hair cells lacked two of the RFX transcription factors. In these mice, hair cells initially developed normally, but then died quickly, leading to rapid hearing loss. By three months of age, the mice were profoundly deaf.

Although the experiments were done in mice, Hertzano says that it is likely that these genes work similarly in humans. Eventually, she says, it might be possible to use our increased understanding of RFX transcription factor to treat hearing loss, by either protecting hair cells from death or fostering their growth. In addition, she and her colleagues think that they will be able to identify other genes that have an important role in hair cell function.

Hertzano first got interested in the genetics of hearing as an MD-PhD student at Tel Aviv University, and then pursued residency training at the UM SOM Department of Otorhinolaryngology, where she now works as a scientist and a surgeon whose practice is focused on diseases of the ear and hearing restoration.

The current paper appeared in conjunction with another paper published in Nature Communications, by Matthew W. Kelley, PhD, a neuroscientist at the National Institute on Deafness and Other Communication Disorders. Kelley and his team also used mice with fluorescent markers in different cells of the ear followed by next generation sequencing. Rather than analyzing groups of cells, they performed a comprehensive analysis of the genes that are expressed in the different cells at a single cell resolution. Their study is the first of its kind in the ear field and helps resolved the molecular aspects of the cellular complexity of the inner ear.