ISSN: 2044-9038 (Print) 2044-9046 (Electronic)

Clinical Practice

Perifollicular Micro Inflammation Open Access Articles:

 Chronic inflammation at the level of the follicle appears to be a common thread in all types of hair loss – a view supported by the wealth of research showing that even in traditionally ‘non-inflammatory alopecia’s’ like poor nutrition, as well as mediators of psycho-emotional stress (eg, cortisol and corticotrophin releasing hormone) all contribute to dysregulation of complex follicle biology. Disruption of immune pathways affecting the follicle occurs through increased expression of pro-apoptotic and pro-inflammatory cytokines, perifollicular micro-inflammation, and release of reactive oxygen species (ROS). As we accept the multi-factorial nature driving hair loss, we can adopt new strategies to combat it, by aiming not at one, but at multiple targets. The rationale for this paradigm shift in hair loss therapy is the scope of this article. Herein is an update on our current understanding of hair physiology and the factors that have been scientifically demonstrated to influence hair follicle homeostasis and contribute to hair loss pathology. Hair loss is chronic and progressive without treatment, affecting at least 50% of women by age 50 and 40% of men by age 35 (progressing to up to 70% in later life). Hair is an important part of our appearance and social communication. It is therefore no surprise that its loss can cause significant psychological trauma in patients, which is further precipitated by the limited available treatment options that produce only variable results with chance for side effects. Currently the only two FDA-approved

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